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Sudden fever, shortness of breath and pain in the throat when swallowing or opening the mouth, which radiate into the ears, indicate acute tonsillitis. Children and adolescents are particularly affected by the chronic form, i.e. when inflammation occurs several times a year. The most common clinical picture in ENT medicine is then the question of whether surgery or conservative treatment should be used.
A new treatment guideline recommends surgery for six tonsillitis per year. Depending on the individual circumstances, surgery may also be indicated with fewer inflammations per year.
The tonsils consist of a concentrated collection of lymphatic defense cells. They fulfill important defense functions in the immune system. Because this is not yet fully developed in children, they suffer from painful inflammation more often than adults. "If purulent tonsillitis occurs spontaneously, antibiotic therapies relieve symptoms and accelerate the healing process," says Dr. Lothar Bleckmann, member of the HNOnet NRW, an association of resident ENT doctors. "Anti-inflammatory tablets, throat sprays and paracetamol for fever and pain can also help a lot."
Sometimes tonsillitis occurs again and again. About six times a year, otolaryngologists speak of a chronic form. Then the new guideline recommends surgical removal of the tonsils. Depending on the severity of the symptoms, it may also make sense to operate on fewer tonsillitis per year. The patient must make this decision together with the doctor.
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"Although the operation is considered routine, sometimes there is a higher susceptibility to infection after the tonsils have been removed," says Dr. Bleckmann. "For younger patients between three and six years of age, ENT doctors often only perform a partial surgical removal." In Germany, the so-called tonsillotomy is carried out in hospitals, medical practices, or operating theaters.
The procedure usually takes about 20 to 30 minutes, is performed under general anesthesia and the patients go home the same day. The success rate for improving the symptoms is over 90 percent. Like any surgical procedure, tonsil surgery also carries risks. Bleeding or swelling of the surrounding tissue are typical risks. Basically, this operation is a procedure with a very low complication rate. (pm)