Tonsillectomies

Tonsillectomy
Cryptic tonsils immediately following surgical removal (bilateral tonsillectomy).
ICD-9-CM	28.2-28.3
MeSH	D014068
MedlinePlus	003013
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Tonsillectomy is a surgical procedure in which each tonsil is removed from a recess in the side of the pharynx called the tonsillar fossa. The procedure is performed in response to repeated occurrence of acute tonsillitis, sleep surgery for obstructive sleep apnea, nasal airway obstruction, diphtheria carrier state, snoring, or peritonsillar abscess. For children, the adenoids (also known as a pharyngeal tonsil or nasopharyngeal tonsil) are usually removed, a procedure called adenoidectomy (or tonsilloadenoidectomy or adenotonsillectomy when combined). Adenoidectomy is uncommon in adults in whom the adenoids are usually vestigial. Although tonsillectomy is performed less frequently than in the 1950s, it remains one of the most common surgical procedures in children in the United States and many other western countries.

Tonsillectomies have been practiced for 2,000 years, with varying popularity over the centuries. The procedure is claimed in some books as "Hindu medicine" about 1000 BC (non-evidence based literature). Others refer to it as cleaning of tonsil using the nail of the index finger. Roughly a millennium later the Roman aristocrat Aulus Cornelius Celsus (25 BC – 50 AD) described a procedure whereby using the finger (or a blunt hook if necessary), the tonsil was separated from the neighboring tissue before being cut out.Galen (121–200 AD) was the first to advocate the use of the surgical instrument known as the snare, a practice that was to become common until Aetius (490 AD) recommended partial removal of the tonsil, writing "Those who extirpate the entire tonsil remove, at the same time, structures that are perfectly healthy, and, in this way, give rise to serious Hæmorrhage". In the 7th century Paulus Aegineta (625–690) described a detailed procedure for tonsillectomy, including dealing with the inevitable post-operative bleeding. 1,200 years pass before the procedure is described again with such precision and detail.