Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tonsillectomy and adenoidectomy, though less frequently performed now than in the 1930s, remain among the most common surgical procedures in the United States. The need for and benefits of tonsillectomy and adenoidectomy have been a source of controversy for several decades. Nonetheless, there are situations in which these procedures definitely are beneficial. Tonsillectomy and adenoidectomy are two distinct procedures with separate indications, and they are performed concurrently only when the specific indications for each coexist. Tonsillectomy is indicated by recurrent tonsillitis, peritonsillar abscess, chronic tonsillitis, tonsillar neoplasm, or tonsillar hypertrophy that is obstructive to the upper aerodigestive tract (respiratory distress, dysphagia, or interference with performance of an adenoidectomy). Adenoidectomy is indicated for nasal airway obstruction due to adenoidal enlargement from hypertrophic or inflammatory processes. Although correlation exists among obstructive adenoids, mouth breathing, and dentofacial anomalies, present evidence is not sufficient to justify adenoidectomy solely on the basis of craniofacial or dentofacial abnormalities. Today, elimination of an occult source of infection (once called focal infection) in patients with disorders such as rheumatic fever or serous otitis media is not a valid indication for either operation. Contraindications to tonsillectomy and adenoidectomy include bleeding disorders, familial anesthetic intolerance, velopharyngeal insufficiency, and concurrent disease that may enhance operative risks. Like all surgical procedures, tonsillectomy and adenoidectomy entail morbidity and risk of mortality. The most frequent complication of these operations is hemorrhage. Risk of mortality is approximately 0.006%. Mortality and morbidity can be minimized by appropriate preoperative evaluation, complete control of the airway with endotracheal anesthesia, and meticulous surgical technique.
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PMID:Current thinking on tonsillectomy and adenoidectomy. 636 11

In this brief study, we describe a rare tumorlike malformation of both tonsils, that we have named tonsilla partim pendulans. It seems to favour intratonsillar bleeding, resulting in enlargement and obstruction of the oropharynx. The presented case is a 34-year-old healthy woman without history of acute or chronic tonsillitis who complained of an oropharyngeal foreign body sensation since 1 day. Examination revealed a dark red and mobile tumor of 2 cm diameter attached to the lower part of the right tonsil. Furthermore, both tonsils showed a division into two hypertrophic parts. The stem of the tumor was coagulated and the tumor resected under local anaesthesia. Histology showed regular lymphoepithelial tissue with acute haemorrhage and an intact capsule. Actinomyces were found in the tonsillar crypts. Further physical and laboratory findings were unsuspicious. We conclude that patients with this newly described malformation of the tonsils can subsequently develop dysphagia, e.g. in combination with inflammation and mechanical stress. However, tonsillectomy seems not to be mandatory, though in more suspicious cases, histological investigation should exclude rare malignant tumors. Intratonsillar bleeding may cause oropharyngeal obstruction or even ongoing bleeding with relevant blood loss, which should be treated immediately.
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PMID:Spontaneous intratonsillar haemorrhage with acute dysphagia. 1802 76