• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.47.1-47.8
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• 2016

Background: The paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients. This study has its purpose in sharing a series of tonsillectomies performed at the Seoul National University Dental Hospital for the treatment and prevention of SDB in adult patients. Methods: Total of 78 patients underwent tonsillectomy at the Seoul National University Dental Hospital from 1996 to 2015, and 23 of them who were operated by a single surgeon (Prof. Jin-Young Choi) were included in the study. Through retrospective chart review, the purpose of tonsillectomy, concomitant procedures, grade of tonsillar hypertrophy, surgical outcome, and complications were evaluated. Results: Twenty-one patients diagnosed with SDB received multiple surgical procedures (uvulopalatal flap, uvulopalatopharyngoplasty, genioglossus advancement genioplasty, tongue base reduction, etc.) along with tonsillectomy. Two patients received mandibular setback orthognathic surgery with concomitant tonsillectomy in anticipation of postoperative airway compromise. All patients showed improvement in symptoms such as snoring and apneic events during sleep. Conclusions: When only throat infections were considered, tonsillectomy was a procedure rather unfamiliar to oral and maxillofacial surgeons. With a shift of primary indication from recurrent throat infections to SDB and emerging technological and procedural breakthroughs, simpler and safer tonsillectomy has become a major tool in the multidisciplinary treatment modality for SDB.

• Korean Journal of Head & Neck Oncology
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• v.24 no.2
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• pp.179-183
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• 2008

Objective：To evaluate efficacy and postoperative morbidity in tonsillectomy using the harmonic scalpel vs conventional electrocautery. Materials and Methods：1) We compared intra-operative bleeding and operation time and analyzed the degree of pain, oral feeding and the ability to return to normal activities from the questionnaire. 2) Animal study：Using rats, we made each linear wound with harmonic scalpel or electrocautery, then compare the width of thermal injury area with trichrome stain. Result：Harmonic scalpel tonsillectomy had significant advantages over electrocautery tonsillectomy in terms of post operative pain, oral diet tolerance and the time of return to normal life. In addition, it increased patients’ overall satisfaction with the surgery. In animal study, it was found that the thermal injury was less severe in the wound caused by harmonic scalpel than by electrocautery. Conclusion：Harmonic scalpel tonsillectomy decreases the thermal injury of the adjacent tissue, thus it has advantages over electrocautery in post tonsillectomy morbidity.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.437-441
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• 2010

Purpose: The aim of this study is to evaluate the incidence and characteristics of tonsillectomy complica-tions, especially about postoperative hemorrhage. Materials and Methods: This study was performed by reviewing the chart of patients who had been operated tonsillectomy in the Cheongju Hankook hospital from 1997 to 2006. Results: Postoperative hemorrhage was occurred to 13.66% of patients. 9.76% of patients had a mild hemorhage but, 3.9% of pateints had a severe hemorrhage which was controlled under general anesthesia. Conclusion: Post-tonsillectomy hemorrhage can lead to expire of patient if uncontrolled. So, operator should have thorough knowlegde about anatomy of tonsil and, manage the complication.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.115-118
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• 2011

Background and Objectives : The voice change occurs after tonsillectomy and adenoidectomy. This study was designed to examine the postoperative nasalance changes using Nasometer. Materials and Method : From April 2009 to February 2010, data of twenty-eight patients who underwent tonsillectomy, tonsillectomy & adenoidectomy were evaluated. 12 males and 16 females were chosen. Nasalance test was performed before, after 1 week, after 1 month from the surgery. Results : Postoperative mean nasalance results statistically significant increased in 1 weeks after surgery, and returned to the preoperative state in 1 month after surgery. Conclusion : Although the nasalance increased immediately after tonsillectomy and adenoidectomy temporally, it was recovered 1 month after surgery. Therefore, the voice change that come postoperatively could be considered as no concern, and surgeons need to aware of various facts, which can affect voice changes before the surgery.

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.62-65
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• 2001

Subcutaneous emphysema of the head and neck are well-known sequealae of surgery and trauma to the chest airway. This occurs when air is introduced into the tissue. This can happen as a complication during, or immediately after surgery. Among the causes subcutaneous emphysema due to complication of tonsillectomy, has rarely been described. Definitive treatment will depend on the cause. Recently. we have experienced two cases of subcutaneous emphysema without respiratory and circulatory insufficiency as a complication of tonsillectomy in 38-year-old male and uvulopalatopharyngoplasty in 41- year-old male.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.54-57
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• 1997

Background : The tonsillar region is innervated by the sensory components of the glossopharyngeal nerve(IX) which communicates with certain part of cervical sympathetic ganglion. Some authors suggest stellate ganglion block(SGB) is effective for treatment of recurrent tonsillitis. The goal of this study was to evaluate the effect of SGB in controlling pain after tonsillectomy. Methods : Forty five patients, evaluated to ASA class 1 and 2, scheduled for tonsillectomy under general anesthesia were randomly assigned to 1 of 3 groups (group I: control; group II: SGB with 1% lidocaine 5 ml; group III: SGB with 2% lidocaine 2.5 ml plus 0.5% bupivacaine 2.5 ml), SGB was performed at the end of surgery. Postoperative pain was assessed with Numeric Rating Scale(NRS) NRS assessment was made 30, 60, 90 min, 2 h, 4 h, 24 h, 48 h after tonsillectomy. Results : Pain scores, after 30 min in group II, III and 60, 90 min in group III were significantly lower than group I(p<0.05). Conclusions : We found SGB was effective in controlling pain after tonsillectomy but further studies are required needs to prolong duration of relief..

• Journal of Korean Clinical Nursing Research
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• v.19 no.1
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• pp.143-151
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• 2013

Purpose: The purpose of this study was to evaluate the effect of illustrated children's book in providing information about tonsillectomy to improve post tonsillectomy pain control and compliance to treatment for preschoolers. Methods: The design of the study was a quasi-experimental, post-test only design. Subjects were preschoolers aged between 3 and 7 years old who were admitted to a hospital for tonsillectomy. A group of 25 children were assigned to an experimental group, and another 25 were assigned to a control group. The data were analysed using SPSS 12.0 program. The homogeneity between two groups was examined using $x^2-test$. The hypotheses testing was conducted using t-test. Results: The experimental group had lower pain score than control group at 8 hour after tonsillectomy (p<.05). Pain score was also lower in the experimental group after 24 hour after the surgery (p<.05). The experimental group had higher pain questionnaire score than control group at 8 hours after surgery, however the difference was not significant. The experimental group showed better compliance to treatment than the control group (p<.05). Conclusion: Providing illustrated children's book for the purpose of providing information about tonsillectomy was effective intervention for the control of post tonsillectomy pain and improvement of compliance to treatment for preschoolers. Illustrated children's book could be applied as a nursing intervention to relieve post tonsillectomy pain and improve compliance to treatment for preschoolers.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.1
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• pp.33-38
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• 2007

Background and Objectives: It has been suggested that tonsillectomy possibly causes changes of voice because the morphology of the vocal tract is altered. This may cause serious problems for professional voice users. Materials and Method: Subjects were 26 patients. The oral and nasal sound spectrum of oral vowel /a/, /e/ and /i/ were measured before and after tonsillectomy. The formant frequencies and intensities for oral and nasal spectra were compared. The nasality and fundamental frequencies for oral vowel were measured. Results: The first formant frequencies for oral spectra of all vowels were not changed after surgery, but the second formant frequencies were increased significantly after surgery in the vowel /e/ and /i/. The first and second formant intensities for oral spectra were increased significantly after surgery in the all vowels. The first and second formant frequencies for nasal spectra of all vowels were not changed after surgery, but their intensities for nasal spectra were increased after surgery. The nasalities for oral vowel were not changed after surgery. Conclusion : Tonsillectomy appeared to change the spectral features of oral and nasal components of oral vowel, especially spectral intensities.

• Korean Journal of Head & Neck Oncology
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• v.28 no.1
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• pp.16-18
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• 2012

Ipsilateral tonsillectomy and panendoscopy-guided biopsy following imaging studies are considered a standard procedure in the search for a primary origin in patients with cervical metastatic carcinoma of unknown origin(MUO). However, many authors recommended bilateral tonsillectomy for the determination of the primary site of a MUO, because cervical metastasis may occur contralateral to tonsillar carcinoma. The authors attempted to address the clinical implications of using routine bilateral tonsillectomy to determine the primary site of MUOs based on a case report of cervical MUO that was finally diagnosed as a bilateral synchronous tonsillar carcinoma with cervical metastasis after a diagnostic work-up that included bilateral tonsillectomy.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.660-662
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• 2005

It is well documented that adenoidectomy is attributed to hypernasality in certain cases, but not clear that the enlarged tonsils affect the quality of speech. Hypertrophied tonsils may cause and complicate the problem of velopharyngeal incompetency. The huge tonsils prevent lateral pharyngeal walls from a medial movement and interfere velar elevation, being hypernasality. Hyponasality developes as the tonsils encroach in nasopharyngeal space. Voluminous tonsils also interfere airflow in the oropharyneal passage and produce the phenomenon of cul-de-sac resonance or muffled sound. The authors and et al. present a case of velopharyngeal insufficiency accompanied with hypertrophic tonsils. Improving the lateral constricting pharyngeal wall and velar elevation after tonsillectomy minimized the velopharyngeal gap. Accordingly, the procedures of sphincter pharyngoplasty and palatal lengthening resolved the problem of hypernasality instead of pharyngeal flap. Tonsillectomy prior to pharyngeal flap surgery tends to reduce the postoperative airway problems. Sometimes, however, only tonsillectomy does without pharyngeal flap. Surgical approach by stages and intermittent evaluation are recommended at intervals of at least six weeks.