Tonsillectomy and adenoidectomy in Iran

Tonsils and adenoids as a part of the immunity system act as a filter to the mouth and nose infections. So that, it exposes for recurrent and chronic inflammation, because of these inflammations, they become larger and cause serious symptoms that do not response to the medical treatments, then surgery will be the best option. However, surgery needs a highly experienced team of surgeons and a good hospital and equipment that may be not available in your country. Besides, the cost of this surgery might be a large sum of money in your country. For these reasons, Iran may be the best option for your surgery since tonsillectomy and adenoidectomy in Iran are performed in high quality with some the best ENT surgeon like Dr. Saeedi at affordable costs.

Please continue reading to know more about the surgery and the benefits of having tonsillectomy and adenoidectomy in Iran with Dr. Saeedi.

What are tonsils and adenoids?

Tonsils and adenoids are lymphoid tissue glands that form a part of the immunity system in the body. By filtering the fluid that runs through the lymphatic system, they play an important role in protecting and defending their areas against the viruses and bacteria.

Tonsils are located in the upper part of the throat (pharyngeal tonsils), while adenoids are located in the back of the nose. Being the first line of defense against viral and bacterial invasions, tonsils suffer from severe inflammation that may spread to the adenoids and nearby tissues. Tonsillitis and adenoiditis mostly affect children aged between 2-12 years, and seldom happen in infants younger than 2 years.

What are the causes of tonsillitis and adenoiditis inflammation?

Both tonsils and adenoids suffer recurrent inflammations. Most of them are due to the viral causes, while the bacterial causes (usually streptococcus) may form about 15- 30% of inflammations. In some rare cases, the inflammation may be a result of immunological factors.

Some types of streptococcus (group A beta streptococci) may infect the tonsils and spread to a new areas where it is not usually found. If it is not treated well with antibiotic for ten days, it may cause a rheumatic fever and affect the joint, kidneys, and heart valves. It essentially affects children in ages 5 to 15 years.

Tonsillitis and adenoids symptoms

The Patient of acute tonsillitis may suffer from the following symptoms:

• Fever
• Sore throat
• Foul breath
• Dysphagia (difficulty in swallowing)
• Odynophagia (painful swallowing)
• Tender cervical lymph nodes
• Airway blockage may appear with mouth breathing, snoring, sleep-disordered breathing, night breathing pauses, or sleep apnea (obstructive sleep apnea syndrome (OSAS)).This can have considerable physical and mental effects in children.

In advanced cases, a peritonsillar abscess (PTA) may be associated with severe symptoms.

Tonsillitis and adenoids complications

The complication of tonsillitis and adenoids are very rare now, because of the developed medical and surgical treatments. Scarlet fever, the main cause of the children who died in the past, as well as rheumatic fever that were essential reasons for cardiac diseases and morality, had nearly diminished. Now, sleep apnea and recurrent throat sores are the prominent complications that summon surgery. However, specialists are increasingly tending now to conservative treatment, to wait and watch. While the surgery remains the last option.

What is tonsillectomy adenoidectomy surgery?

Tonsillectomy and adenoidectomy surgery is a surgical procedure in which tonsils and adenoids are removed. When the surgeon usually removes the tonsils, he/she used to take off adenoids as well as. Now, the surgeon may do tonsillectomy without a denoidectomy, or adenoidectomy alone, or adenoidectomy and tonsillectomy. The surgeon may also use a tonsillectomy adenoidectomy and turbinoplasty reduction through the nose, treat the difficulties of breathing and resection of adenoids, and/or amend abnormalities of the nasal septum (septoplasty).

Tonsillectomy and adenoidectomy may be associated with myringotomy with/without grommets for media otitis when fluid and pus accumulate in the middle ear for at least three months without responding to medical treatment. The surgeon makes an incision or/and inserts an ear tube through the tympanic membrane for draining the fluids.

The surgeon may eradicate the tonsils and their capsules (total eradication), or cut off the tonsils alone and retain their capsules (partial eradication) to lessen the complications.

The tonsillectomy surgery is alike for adults and children, but the cases of tonsillar malignancy are higher in adults than in children due to smoking, alcohol and environmental factors. This means the risk factors and the necessity for histopathological examination after surgery is higher in adults and the recovery time is longer.

Why opt for tonsillectomy and adenoidectomy in Iran?

Iran has distinguished medical facilities, hospitals, clinic, high- quality equipment, and you can have surgery in Iran with no waiting time, not to mention their excellent doctors. Above all, the affordable prices for their medical services, because of their cheap currency, makes Iran a hub for medical tourism, where many patients from all over the world come to Iran to have their surgeries done with the same quality of the most medically-developed country at very good prices.

As well, you can enjoy their historical, cultural items and their marvelous nature.

Why to have tonsillectomy and adenoidectomy in Iran with Dr. Saeedi?

Dr. Masoumeh Saeedi is one of the best ENT surgeons and otolaryngologists in Iran. She is specialized in ENT since 15 years and she has a fellowship in head and skull base surgery.

Since then, Dr. Saeedi has performed more than 5,000 successful complex surgeries for both Iranian and international patients visiting the country for treatment. In addition, she is an associate professor of ENT in Baqiatallah University of Medical Sciences in Tehran. She was honored with this professorship since she was only 33 years old because of her distinction.

To stay in touch with the most developed techniques and technologies in the world, Dr. Saeedi has also passed many specialized courses in countries like France, Portugal, Malaysia, South Korea and Germany to name few. Please contact us now to have a free online specialized consultation on tonsillectomy and adenoidectomy in Iran with Dr. Saeedi through the Doctor’s social media channels or through this website.

Who is to undergo tonsillectomy adenoidectomy surgery

There are numerous reasons for tonsillectomy adenoidectomy surgery. Thus, every case needs a special evaluating to decide for surgery. However, the most uncontroversial cases are within these ranges:

• Individuals (likely children) who suffer from sleep apnea that may appear as irritability, trouble focusing and poor school performance.
• Individuals who suffer from recurrent or chronic tonsillitis: seven recurrent tonsil infections within one year, or five infections per year over a two-year period, or three infections annually over three years.
• Adults who suffer from the foul breath due to recurrent or chronic tonsillitis and Peritonsillar abscess that do not respond to the conservative treatment. In addition, the procedure is safer and easier for infants than older children and with no more special complications.
• Individuals who suffer from a chronic ear or sinus infection or permanent nasal obstruction may need adenoidectomy, at the same time with tonsillectomy or instead of it.
• In cases of tumors.

Preparation for tonsillectomy adenoidectomy surgery

The parents should explain and adapt their child for tonsillectomy adenoidectomy surgery, and the doctor should explain the possible risks of the surgery and ask about the medical record of the child and his/her family diseases. After that, the surgeon may demand:

• To stop aspirin or other medication containing aspirin or blood thinner for ten days before surgery.
• Not to eat or drink after midnight before the surgery.
• Some general examinations and blood test

Tonsillectomy adenoidectomy surgery: How is it done?

Tonsillectomy adenoidectomy is an outpatient surgery. It needs general anesthesia. The surgeon eradicates the tonsils and their capsules and adenoids, or the tonsils alone, with stainless steel scissors and scalpels. There are many techniques for doing the procedure, but they are divided in two main ways; the first is called “cold steel” in which the surgeon use scalpels and scissors to remove the tonsils. This traditional method is preferred for most ENT specialists. There are some other techniques, in which the surgeon uses heat scalpels in cutting off, and cauterizing the tissues by “hot steel”. The tonsillectomy adenoidectomy surgery duration is about 30-40 minutes.

Some of the new techniques are electrocautery, radiofrequency ablation, harmonic scalpel, thermal welding, carbon dioxide laser, and coblation tonsillectomy with plasma that may cause less pain and fast recovery… etc.

Local anesthesia or spray alone may be used to accompany carbon dioxide laser or some other new techniques to avoid the risk of general anesthesia, and in patients who cannot tolerate it.

Tonsillectomy adenoidectomy surgeryrecovery time: what to expect?

Whatever the kind of surgery is, there are some side effects, like nausea and vomiting, dehydration, eating troubles, ear pain, and voice change for some time as a result of surgery. The hospital provides you with a prescription and strict discharge instructions about the recovery and emergency cases.

The patient’s tonsillectomy adenoidectomy healing process takes usually about 7-10 days.

Tonsillectomy adenoidectomy post-operative care includes encouraging the patient to drink a lot of non-acidic fluids to avoid dehydration. The patient must avoid hard foods in his/her tonsillectomy and adenoidectomy diet. A low-grade of tonsillectomy adenoidectomy fever is acceptable for a few days, but the temperature should not exceed 38.5 centigrade. Hard activities for the patient are undesirable, and children can go to their school when they are eating and drinking well.

Special attention should be paid for fresh bleeding (except for specks from the nose or in saliva).When the bleeding exceeds a spoonful of fresh blood or when there is a vomiting clot, you should go to the hospital.

Pros and cons of tonsillectomy adenoidectomy operation

There are some risks in a tonsillectomy adenoidectomy operation like any other surgery. However, most of them are temporary ones, and the benefits of tonsillectomy adenoidectomy for sleep apnea are undoubted.

Comparative studies indicate that there are some improvements in the reduction of sore throat infections in short terms during the first year after tonsillectomy and no difference with streptococcal infection in long terms. While the surgery itself is safe at a high degree, the successful treatment rates of obstructive sleep apnea/hypopnea syndrome are about 60% of all cases.

Tonsillectomy and adenoidectomy Benefits

The tonsillectomy and adenoidectomy outcomes relating to obstructive sleep apnea syndrome (OSAS) are excellent. Obstructive sleep apnea may have serious mental and physical effects on children, and in the cases of recurrent throat infections. While in cases of dysfunction of the Eustachian tube, or in-ear infections, adenoidectomy is preferable.

Risks and complications of tonsillectomy adenoidectomy surgery

Generally speaking, the surgery is safe, but like any other surgery, there is the risk of anesthesia. The most common complication of tonsillectomy adenoidectomy is bleeding. There are some other temporary risks like nausea and vomiting, dehydration, eating troubles, ear pain, and speaking difficulty. Following the surgeon instructions strictly may lessen the complications and shorten the recovery time.

Tonsillectomy does not seem to diminish long-term immune function and does not increase the long-term risk of infections in the body.

What are the contraindication cases for tonsillectomy adenoidectomy surgery?

The following cases are contraindication for tonsillectomy adenoidectomy surgery:

• Bleeding diathesis
• Poor anesthesia risk or uncontrolled medical illness
• Anemia
• Acute infection

Cost of tonsillectomy and adenoidectomy in Iran with Dr. Saeedi

The cost differs according to the city, hospital and surgeon. However, the cost of tonsillectomy adenoidectomy in the USA starts from 3,500$, while the cost of tonsillectomy and adenoidectomy in Iran with Dr. Saeedi is only a small fraction of this price, so you will be saving a lot of many even if when considering the additional costs of travelling and accommodation. If you or your child have other problems in the ear or the nose, the surgeon may combine many surgeries at the same procedure like septoplasty, myringotomy, etc. Of course, the cost will increase in these cases.

Frequently asked question about tonsillectomy adenoidectomy surgery

Can tonsillitis adenoiditis cause ear pain?

When adenoids become larger than their usual size, they block the airway to the middle ear (Eustache tube), which may cause inflammations and pain in the ear.

Is tonsillectomy adenoidectomy surgery dangerous?

Generally, tonsillectomy adenoidectomy surgery is a safe procedure. However, there are the risks of anesthesia, and bleeding. The death rate after the surgery is about one patient to 3360-56000 patients, so the success rate of tonsillectomy adenoidectomy surgery is about 99%.

Is tonsillectomy adenoidectomy surgery outpatient?

In most cases, the patient discharges from the hospital after a few hours of surgery, while a few patients may stay in the hospital for a night or more according to their health.

Why cannot I just live with my sleep apnea?

Sleep apnea may cause many dangerous diseases like heart attack and stroke. So you should be examined by an ENT specialist to give you the right decision about what to do.

Is it normal for my child to snore?

If the enlarged tonsils and adenoids are the reason, the surgeon will suggest a tonsillectomy adenoidectomy surgery for snoring, lest developing to sleep apnea.

What is the advantage of tonsillectomy and adenoidectomy with coblation?

Coblation tonsillectomy is a new technique, for tonsillectomy surgery. It is done by using plasma to remove the tonsils, accompanied by radiofrequency energy. The plasma field resolves the molecular bonds of tonsils and remains rather cool. This type of operation offers many advantages, including minimizing tissues damage, lessening pain as well as providing faster recovery time in most patients.

Why are the lymph nodes in my neck swollen?

The lymph nodes enlargement usually indicate an infection. These nodes filter the fluid that runs through the lymphatic system. When the swelling lasts for a long time, it is necessary to consult an ENT specialist.

Does tonsillectomy finish the infection with a streptococcus?

Tonsillectomy reduces sore throat infections in a short term, but after that, the infection may recur after surgery. The important matter in these cases of infections is the treatment with antibiotics for ten days.

Is tonsillectomy change my voice?

Tonsillectomy surgery may change your voice, due to the state of inflammatory in the throat after surgery, but it is a temporary side effect.

Does tonsillectomy surgery cause obesity?

Studies indicate that children who underwent the resection of tonsillectomy gain more weight in the first year after surgery, but it is still unknown whether obesity is a result of our lifestyle type or due to the surgery.

Does tonsillectomy surgery reduce immunity?

The medical literature and the observation for a long period show that tonsillectomy does not affect the immunity for the patient who underwent this procedure. Some new research indicates that it may affect the patients who are under 9 years, so they may be at higher risk for respiratory, infectious, and allergic diseases up to the age of 30 years. However, these observations still need more emphasis.

Is tonsillectomy surgery necessary?

Tonsillectomy is one of the most procedures done in the world (about half a million operations in U.S.A. every year) and it gives a reasonable result in treating obstructive sleep apnea/ hypopnea syndrome, where the improvement may reach about 60% in cases of tumors.

The new increasing trend is the conservative treatment, and surgery remains the last option.