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Monday, December 13, 2010


ni makala ya kingereza na unaweza ukaitafsiri ukipenda kwa kuielewa zaidi

 Tonsils and Tonsillectomy
What are tonsils and adenoids?  The tonsils are two clumps of tissue, on either side of the throat, embedded in a pocket at the side of the palate (roof of the mouth).  The lower edge of each tonsil is beside the tongue...way in the back of the throat.  The adenoids are a single clump of tissue in the back of the nose (nasopharynx).  They are located (in the adult) on the back wall of the throat (pharynx)...about one inch above the uvula (the little teardrop shaped piece of tissue that hangs down in the middle of the soft palate). 
What function do they serve?   Aren't they important?  The tonsils and the adenoids are mostly composed of lymphoid tissue, which is found thoughout the gastointestinal tract and on the base of the tongue.  Lymphoid tissue is composed of lymphocytes...which are mostly involved in antibody production.  Since we generally consider antibody production to be a good thing, many studies have been performed to try to clarify the importance of the tonsils.   There seems to be no adverse effect on the immune status or health of patients who have had them removed.  Any noticable effect has generally been positive. It appears that the tonsils and adenoids were not "designed" to effectively handle the multitude of viral infections that occur in children in an urban population.  Rather, the immune system, including the tonsils and adenoids, developed during a era where the child was rarely exposed to a large number of other people and the germs they carried.  It may also be that these organs are relatively more important in dealing with certain types of infections, such as worms or other parasites, that are relatively uncommon in today's society.  It is clear that in many cases, the tonsils and/or the adenoids become "dysfunctional" and are more of a liability than an asset.
How are tonsils removed?   There are many techniques used for tonsillectomy.  General anesthesia is usually employed; but it is possible to perform tonsillectomy with sedation and local anesthesia.  In the United States, some degree of electrocautery assisted dissection is most commonly employed, because of the ability to rapidly stop bleeding.  Some surgeons use very little cautery...with more bleeding, but with less burned tissue.   Use of lasers has been studied and considered by most surgeons.  We feel that laser use is primarily a marketing gimmack at this point, since it offers no apparent advantage over certain cautery techniques, and has some very real hazards and extra costs.
 and this is the type of tonsils you have to know...
1.Blockage of the throat...they are too big.
2.Chronic and recurrent tonsillitis...sore throats
3.White debris in the tonsils..."chronic cryptic tonsillitis".
4.Unusual enlargement or appearance.
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