Laser lacunotomy of the palatine tonsils video. Method of laser lacunotomy of tonsils Who is recommended for laser treatment of tonsils for chronic tonsillitis

I have had chronic tonsillitis for 3 years now. This disease does not bring me any discomfort, and it’s somehow unusual for me to call it a disease. Let me first tell you a little about her.

Chronic tonsillitis usually occurs after prolonged colds, flu, or with reduced immunity. It especially manifests itself in winter in parallel with inflammation of the throat. In the cold season, when the immune system is weakened after a cold and the sore throat has not yet fully recovered, microorganisms, mainly staphylococci, which in a healthy state are suppressed by the immune system, accumulate and multiply in the openings of the tonsils - lacunae. Plus, food particles get into the tonsils, which create an additional breeding ground for microbes. In response to the proliferation of staphylococci, the body begins to produce lymphocytes that neutralize pathogenic microflora. As a result, a mixture of pus, food particles and microbes forms in the lacunae of the tonsils, and purulent plugs are formed. Since the immune system is weakened, the body cannot completely get rid of microbes, the traffic jams become larger, and the microbes penetrate deeper into the lacunae of the tonsils. When a person recovers and the immune system becomes good again, staphylococci finally settle in the lacunae of the tonsils and without treatment the body can no longer destroy them. The lacunae of the tonsils regularly become clogged with plugs, tonsillitis becomes chronic and remains even with good immunity and a healthy state of the person.

From time to time, white plugs emerge from the lacunae of the tonsils - a consequence of tonsillitis. In summer there are almost none, in the cold season there are more of them, and the disease worsens.

In people who have weak immunity and often suffer from colds, tonsillitis can manifest itself not only in the form of traffic jams, but also in constantly elevated body temperature, malaise, and enlarged lymph nodes. I generally have good immunity, I get colds once a year in the winter, sometimes I don’t get sick at all, tonsillitis doesn’t particularly bother me. Just occasionally there are unpleasant traffic jams. I first noticed them about 3 years ago, I didn’t attach any importance to it. A year ago, I became interested in this topic and went to the otolaryngologist, I was prescribed Tonzilgon tablets, rinsing with soda and washing the lacunae of the tonsils. I went to wash it a couple of times, but didn’t notice any results. Washing lacunae, rinsing, taking tablets is a conservative method of treating tonsillitis; many doctors say that tonsillitis can be completely cured only with a laser.

Rinsing the lacunae of the tonsils is an unpleasant procedure, during which the lacunae are washed with an ozonated solution from a syringe with a thin long tube at the end. On one of the sites I found instructions for making a device for cleaning tonsils from an aluminum wire with a loop at the end. So, after washing, I came home, looked into my throat and cleaned out the gaps no less than usual.

I didn’t particularly plan to treat tonsillitis, but recently, during an examination at the clinic, the ENT specialist strongly recommended a lacunotomy. He said that this would solve the problem with tonsillitis once and for all.

I signed up for medical school. center for laser lacunotomy. The price of the operation is 4000 rubles. Another 1000 rubles were spent on the purchase of tablets and aerosol for treating the throat after surgery during the healing period.

The operation itself lasts about 30 minutes. and consists in the fact that, using a laser, the doctor burns out the affected tissue in the lacunae of the tonsils (the affected tissue becomes loose and serves as a breeding ground for microbes). The doctor said that the laser has an immunostimulating effect. The operation is supposed to be bloodless, but I observed bruises on my tonsils for several days, although there was no blood during the operation.

First, they gave me a couple of injections in one tonsil. It's tolerable, just a slight tingling sensation. The tonsil became numb, and the doctor began the operation. Using a device with a short green beam at the end, shaped like a dentist's drill, the doctor began to cauterize the tonsils. It was a little painful, the doctor did the cauterization in fragments, he would bring the laser, hold it in the tonsil for 15 seconds, then take it out, I’ll take a break, after 10 seconds the laser will go into the tonsil again. Unpleasant but tolerable sensations. There was smoke coming from his mouth and the smell of burnt meat. After the first tonsil, the doctor gave anesthesia injections to the second one and also began to cauterize it with a laser. The second tonsil was done for me longer than the first one; apparently, it was more severely affected.

After the operation, I was prescribed antibiotics, Bioparox aerosol, chamomile rinses and painkillers - Ketorol and Nimesil. Nimesil helped me a lot - you drink the powder from one sachet and you can live for a day.

After the operation, my throat and part of my tongue became numb, I could not really speak, I made a muffled gurgle in which words could barely be distinguished. These were only flowers. On the way home, the anesthesia began to wear off. All hell has broken loose. The pain is terrible, unbearable, as if pieces of my tonsils are being cut out alive with a knife. 100 times more painful than cauterization during surgery. A terrible nightmare, my throat has never hurt so much. I cried the second half of the way home, it was terrible pain. At home I drank 2 sachets of Nimesil, 1 tablet of Ketorol, sprayed it with an aerosol and went to bed, when I woke up an hour later, the pain had subsided just a little, the ability to speak had returned.

If you have the opportunity to get painkilling injections, do them immediately after the operation so that it does not hurt as much. And stock up on good painkillers. You can drink after surgery, but you can’t eat for a couple of hours. It hurts to swallow.

On the second day, my throat was very sore, but compared to the first day it was easier. The first day is hell, on the second, third, fourth day the pain is like a severe sore throat, it hurts to swallow. My throat finally stopped hurting only 2 weeks after the operation; within two weeks I had already managed to get used to the constant pain in my throat. The tonsils were covered with a dense white film, now a small white coating remains on one tonsil. The tonsil that was burned more strongly hurt longer. Do not forget to take the prescribed antibiotics, otherwise everything will fester in the tonsils.

Now the tonsils have stopped hurting, but still have not healed. Now I’ll write about efficiency.

I don’t know how tonsillitis should go after surgery; the ENT specialist didn’t really explain this to me. The fact is that about three days ago I finally looked into my throat and cleaned out a lot of plugs with my wire. Maybe it’s old plugs that were there before the operation coming out, or it’s tissue that has died as a result of healing. I haven't gotten this many plugs before. Maybe old remnants are coming out of the burnt out gaps. I would like it, and the doctors promise that the traffic jams will disappear. I want to believe it. No wonder I suffered. I read on the forums that some people did lacunotomy 5 times, and there were no results. But my case is not so severe; in the summer I completely forget about tonsillitis. I think I would have had a lacunotomy sooner or later anyway. I will come back and add updates as I observe them.

I decided to write a review for those who are interested in methods of treating tonsillitis. On the Internet I only read about the results of the operation, but the process itself is not written anywhere, so I hope that I have clarified the situation a little. On Airekommenda I also saw reviews about tonsil removal and tonsillotomy, but tonsillectomy, tonsillotomy and lacunotomy are three different operations, so I decided to create a separate thread.

I hope my review was helpful to you. If you have any questions, ask.

UPDATE (07/08/2014)

5 weeks have passed since laser lacunotomy.

At first I had mixed opinions about this operation. On the one hand, many doctors recommended lacunotomy to me as the most modern and effective method of treating tonsillitis. On the other hand, in the first 2-3 weeks it seemed to me that this was an ineffective operation. There were still traffic jams. It seems to me that this was due to the fact that the tonsils had not completely healed, and the laser only cauterizes the lacunae, and if there are plugs in the depths of the lacunae, then the laser will not get rid of them, they will still come out like with tonsillitis.

I was upset that after this painful operation, the plugs in the lacunae of the tonsils still remained, and quite a lot. And closer to the tongue, it was as if another lacunae of the tonsils appeared (I apparently hadn’t noticed them before), from which plugs also came out (the ones closer to the palate burned me). This was on the 3rd week after lacunotomy.

I stocked up on chlorhexidine and cleaned and washed the lacunae of my tonsils almost every day. I adapted to bringing the spout of the chlorhexidine bottle close to the lacunae, pressing the bottle, feeling how the chlorhexidine was washing out the lacunae and not just pouring down the throat. The feeling is not pleasant, but after a couple of days I got used to it. I did this for 10 days.

Gradually, I began to notice that there were almost no plugs in the lacunae, after 10 days of washing with chlorhexidine, I did not even notice that the tonsils became clean, I again stopped noticing those second lacunae of the tonsils that were not cauterized.

Over the last 2-3 weeks, I tried to rinse the lacunae of the tonsils a couple of times, but I got out of the habit of this procedure and it became very unpleasant for me, I began to vomit. And during these 2-3 weeks, I never noticed any plugs in my tonsils, although previously they appeared 5 days after washing.

Now I don’t wash the lacunae of the tonsils, and there are no plugs in them at all, for 2-3 weeks now. The tonsils themselves even seemed to shrink. Previously, almost always, especially in winter, I had wheezing in the morning. Apparently, during the night the tonsils and the area of the throat next to them swelled, I did not suffer from anything, but in the morning I still spoke hoarsely, there was a feeling of a lump in my throat. After the lacunotomy, my throat healed within 2 weeks, and somehow, unexpectedly for myself, I noticed that I no longer wheezed in the morning.

Overall, I'm glad I had the lacunotomy. After my throat has finally healed and all the accumulated plugs have come out, I don’t find any new plugs, my tonsils have shrunk a little, I stopped wheezing in the morning, there is no feeling of a lump in my throat. Sometimes I gargle with chlorhexidine as a preventative measure.

UPDATE 11/30/2014

The review turned out to be huge, but I want to add more to it.

Almost six months have passed since the lacunotomy. With the onset of the first cold weather, I caught a cold and had a sore throat. During these six months, tonsillitis hardly showed up, there were very few traffic jams, but with acute respiratory infections it usually worsens. And then I caught such a cold that my lymph nodes even became enlarged and my tonsils became a little larger. The traffic jams have not disappeared; there are also a little more of them than usual. Not as much as it was before the lacunotomy, but the tonsils are not absolutely clean. And there seem to be more holes on the tonsils, where they were cauterized, there are almost no plugs, but they appear in the gaps located a little higher. And sometimes unpleasant sensations appear, as if there are plugs somewhere in the palate that cannot be removed.

According to my feelings, in order to cure tonsillitis, you need to do 2-3 lacunotomies on different lacunae of the tonsils; one operation will not get rid of tonsillitis.

UPDATE 02/14/2015

Perhaps I'll write another update. The review is long, but I think it will be interesting to read for those who also have tonsillitis or those who want to do this procedure.

The flu did not pass me by, when many people around me got sick, I, of course, got sick too. The temperature rose, the throat hurt, and a cough appeared. Previously, these symptoms were accompanied by an increased number of plugs in the lacunae of the tonsils.

And now... In general, no matter how much I tried to clean out the tonsils, no matter how much I used my specially adapted wire, I did not find a single plug. Where the lacunotomy was done, there are now no traffic jams at all! I've forgotten about them for the last few months. At the same time, my immunity is now lowered, in the middle of winter I get sick easily, but my tonsils are clear. I was surprised myself. I did it in May, now it’s February, more than six months have passed, the plugs in the tonsils themselves seem to have disappeared. After the lacunotomy there were a lot of them, especially when the throat was healing, in the summer I periodically removed them, and in the fall there were a lot of them. And then somehow they gradually disappeared, although I did not treat them purposefully, I only gargled during a cold. Maybe lacunotomy has such a long-term effect. I would like to hope that these plugs will not appear again, and tonsillitis will no longer bother me.

UPDATE 07/09/2015

A little over a year has passed. I will write briefly, because... So, in a huge review, everything is almost described.

I get acute respiratory infections about 2 times a year. Neither when I am sick nor in normal times am I bothered by plugs in the lacunae of my tonsils. About a month ago it was just a little bit, just a small dot on the surface, it doesn’t even count as a cork. And when I try to squeeze them out like before, they still aren’t there. This is the effect of the operation. In the first months there were a lot of them, but now there are none at all, although I didn’t gargle additionally to remove them.

Treatment of tonsillitis with a laser is one of the most innovative and effective means of combating the chronic inflammatory process in the tonsils, which is aimed at completely ridding the patient of pathogenic microflora in the tissues of the tonsils and at the same time allowing doctors to keep this part of the throat intact. All these efforts of doctors are connected with the fact that the tonsils play an important role in the formation of a strong immune system of the patient, acting as an organic filter that blocks the further advancement of infectious microorganisms and pathogenic viruses into the respiratory tract. Laser treatment of tonsillitis has its advantages, as well as contraindications for use. Let's take a closer look at the pros and cons of laser cauterization of inflamed tonsils.

Laser lacunotomy is a molecular resonance destruction of the palatine tonsils, on the surface of the mucous membrane and in the deeper tissues of which an acute or chronic inflammatory process provoked by an infectious infection develops. Lacunotomy using a laser beam is considered one of the least traumatic methods of surgical treatment of tonsils. Especially if the patient is experiencing an exacerbation of the disease, swelling and redness of the mucous membrane of the tonsils develops.

The mechanism for carrying out this type of therapeutic procedure is as follows:

A surgeon who has permission to conduct surgical treatment using a laser and auxiliary equipment that provides a continuous flow of the laser beam injects the tonsil area with local anesthesia. This stage of treating tonsillitis with laser therapy is the most painful. The patient must endure the administration of an injectable pain reliever.
After the anesthesia takes effect and the patient loses sensitivity in the tonsil area, the surgeon begins to apply a laser beam to the surface of the tonsils.
The specialist dissects the lacuna with a hot laser stream, in which there are excessive amounts of purulent plaques and a huge amount of pathogenic microflora. During these manipulations, purulent contents and pathogenic microbes are simultaneously removed, and the doctor also gets the opportunity to immediately cauterize the operated area of the throat in order to avoid heavy blood loss.

Under the influence of high temperatures of the laser beam, thermal excision of infected tissues occurs and the chronic spread of bacteria throughout the body is stopped. After 2-3 days, due to catarrhal processes that develop in the tissues of the tonsils upon completion of the procedure, necrosis and rejection of the epithelial surface that has undergone laser carbonization occurs. This process slows down the complete healing of the operated tonsils for several days, but after 3-4 days the epithelial cells of the tonsils regenerate with the same intensity. The process of complete recovery and rehabilitation is highly individual and depends on the age of the patient, the severity of the clinical picture of acute or chronic tonsillitis that was diagnosed in the patient. In general, the optimal indicator for tissue restoration of operated tonsils using a laser is 10 days.

Who is recommended for laser treatment of tonsils for chronic tonsillitis?

Laser treatment of tonsillitis is an analogue of tonsillectomy, when a bacterial infection has affected the tonsil tissue so much that conservative treatment using traditional medications no longer brings the expected therapeutic effect. Therefore, the otolaryngologist and the patient himself are faced with the question of complete removal of the tonsils using surgical equipment, or performing therapeutic manipulations with a laser, cauterizing the affected areas of the tonsils and preserving the functional abilities of this organ. Laser therapy for tonsils is recommended in the following cases.

Frequent exacerbations

If a patient with a chronic form of tonsillitis experiences an exacerbation of the disease more than 3 times a year, then this is a direct indication for laser sanitation of the infected areas of the tonsil tissue. In the absence of this treatment, the number of exacerbations of tonsillitis will only increase every year.

Negative reaction to conservative treatment

Therapy for chronic and acute tonsillitis always begins with the patient undergoing a course of medication, the use of potent antibacterial drugs, and antiseptic solutions for gargling. If during therapy there is no positive reaction and the patient’s condition does not improve, the inflamed tonsils remain swollen and painful, and purulent plaques continue to fill the lacunae of the tonsils, then this is a direct indication for laser therapy for tonsillitis.

Development of complications

Tonsillitis is an infectious disease that is most dangerous due to the development of its complications. If, during a comprehensive examination or based on complaints received from him about unsatisfactory health, diseases such as infectious myocarditis, rheumatoid arthritis, peritonsillar abscess, signs of blood poisoning, and the development of acquired heart disease are discovered, then with 85% probability it is possible to assume that these pathologies were provoked precisely by the presence of chronic or acute forms of tonsillitis in the patient. Loss of precious time and lack of treatment for tonsil tissue in the future threatens the patient with even more acute complications with damage to vital organs.

If a patient with tonsillitis has these concomitant pathologies, lacunotomy is one of the mandatory therapeutic methods for restoring the functionality of the tonsils in order to avoid their surgical removal.

Contraindications to the cauterization procedure

Lakunotomy not only has advantages and is highly effective in terms of its impact on infected tonsils, but also has medical contraindications for use. It is strictly forbidden to treat tonsils using a laser beam in the following cases:

the patient has an infectious disease in the acute phase of development with signs of profuse suppuration and the formation of multiple plaques (it is recommended to relieve the inflammatory process with antibacterial drugs and only then proceed to the lacunotomy procedure);
the development of malignant tumors in the patient’s body, regardless of the type of cancerous tumor, as well as the area of its localization (this prohibition is justified by the fact that laser irradiation can provoke a more accelerated growth of degenerated cells and then the tumor will begin to develop even more intensively);
various diseases of the pancreas, as well as diabetes mellitus types 1 and 2 with high or low blood glucose levels;
heart failure, lung diseases associated with a sharp reduction in the bronchial lumen and the further development of acute spasm of the respiratory tract;
too low level of platelets in the blood, which provokes poor blood clotting, leads to frequent bleeding (lacunotomy itself is characterized by minor blood losses, since the laser not only removes the affected tissue of the tonsils, but also immediately cauterizes them, but there is always a risk touch a major vessel and cause heavy blood loss);
the presence of a state of pregnancy, as well as breastfeeding (these restrictions are justified by the fact that at this stage of a woman’s life any stressful situations are strictly contraindicated, and lacunotomy is still an operation during which not a scalpel is simply used, but a hot laser beam);
Children whose age ranges from 1 year to 10 years should also not undergo laser therapy for chronic tonsillitis.

These are the main medical contraindications that prohibit laser excision of infected tissues of the tonsils, since the development of much more dangerous complications is possible.

If these pathologies are present, the otolaryngologist selects other treatment methods for the patient, based on conservative therapy or traditional surgery. This is already determined by the doctor on an individual basis.

How much does laser therapy for tonsillitis cost (average price per procedure) and is one procedure sufficient for results?

The cost of laser therapy for tonsillitis by sanitizing diseased tonsils using a laser beam directly depends on the city in which the procedure is performed, in a public or private clinic, and also indirectly on the individual pricing policy of the specialist who conducts this type of treatment. On average, the price range for lacunotomy is between 1200-1500 rubles per procedure. In most cases, it is not possible to completely get rid of inflammation in the tonsils in just one session and you may need to undergo 2-3 laser therapy procedures. Based on the results of completion of treatment, 10 days later the patient undergoes a follow-up examination and the doctor determines the need for a second course of therapy, or at this stage the treatment is completely completed and the patient has recovered.

Chronic tonsillitis is a pressing problem, since its prevalence among the Russian population is very high. Previously, practically the only method of treating this disease was removal of the tonsils. Such treatment has its drawbacks, because the tonsils perform an important barrier function.

Nowadays, to combat purulent plugs in the tonsils, a surgical technique is used, which is based on partial “evaporation” of pathological areas. The features of this treatment method will be discussed in detail in this article.

What is laser lacunotomy, how does it differ from tonsillotomy or tonsillectomy - the advantages of the procedure

Human tonsils consist of holes - lacunae, in which pathogenic microorganisms accumulate during long-term inflammatory diseases of the throat. In particular, we are talking about staphylococci.

If the immune system is strong enough, pathogenic microflora is suppressed with its help.

However, in the winter season, against the background of colds, the body’s defense reactions are reduced, which makes them unable to fully cope with these pests. Pieces of food that fall into the lacunae, as well as lymphocytes produced by the body in response to an attack by staphylococci, contribute to the pathological process.

As a result of all this, purulent plugs form in the openings of the tonsils, which become more numerous over time, and they penetrate deeper into the lacunae. When the body fully recovers from certain inflammatory ailments, staphylococci firmly occupy their positions in the openings of the tonsils - and, without appropriate therapeutic measures, it is no longer possible to destroy them.

Thus, chronic tonsillitis is formed, which, even in people with strong immunity, manifests itself as white plugs that periodically come out of the lacunae and have an unpleasant odor.

The lack of adequate treatment can cause serious exacerbations.

By doing laser lacunotomy the surgeon acts only on problematic lacunae, leaving healthy tissue unaffected. This technique is relevant today, because with its help you can preserve the tonsils, which perform an important protective function.

After this manipulation, the tonsils are completely cleared of purulent plugs - and fully carry out their work.

At tonsillotomy partial resection of the tonsils is performed, with tonsillectomy– their complete removal.

Advantages of laser lacunotomy:

There is no bleeding during the procedure, which minimizes the risk of complications in the future. The laser beam cauterizes the lacunae, thereby making the operation bloodless. In extremely rare cases, minor bruising may occur in the first days after surgery.
Spot treatment of the working area makes it possible to preserve healthy tissue as much as possible and eliminate pathological ones.
No need for hospitalization. Lakunotomy is performed on an outpatient basis, after which the patient is sent home.
This procedure can be performed on children as young as 3 years old.

Indications for laser treatment of tonsils

Patients need the manipulation in question in the following cases:

Symptoms of tonsillitis appear more often than twice a year.
The presence of adhesions and/or scars on the surface of the tonsils. These formations can serve as a source of infection.
Purulent plugs are permanent, and therapeutic measures cannot eliminate them.
Diagnosing complications in patients in the form of malfunctions of the kidneys, heart, and joints. Although this point is controversial among doctors. Some experts believe that when these exacerbations develop, it is better to completely remove the tonsils than to treat them.
Large tonsils, which negatively affects respiratory function.

Contraindications to laser lacunotomy

This procedure may not always be applicable.

There are certain contraindications to it:

Inflammatory phenomena that occur in an acute form, as well as exacerbation of chronic infections. In such a case, the operation is postponed until recovery.
Oncological diseases. This is especially true in cases of pathological tumors in the throat.
Diabetes.
Serious disturbances in the functioning of the heart.
The period of bearing a child.
Mental disorders.
Pathology in the functioning of the respiratory system.

Preparation for laser cauterization of tonsils or laser lacunotomy and surgical technique

A few days before the procedure in question, the patient is sent for a biochemical and general blood tests. In some cases they take throat swab, which is subsequently sent to the laboratory for examination under a microscope, as well as for seeding.

Mandatory oral sanitation before laser lacunotomy.

If the patient is impressionable and takes the upcoming manipulation too seriously, the day before the lacunotomy he should drink sedatives.

Despite the fact that cauterization of the tonsils is a bloodless procedure, if a person has problems with blood clotting, drugs are prescribed that help increase clotting. They should be taken for two weeks before surgery.

On the day of cauterization of the tonsils, you must refrain from eating and also brush your teeth.

The algorithm of the procedure under consideration is as follows:

Anesthesia. Lidocaine injections into the tonsils are often used. First, a couple of injections are given in one tonsil. After its cauterization is completed, do the second one.
Actually cauterization. The patient remains in a sitting position throughout the procedure. In this case, the manipulator does not come into contact with the working area: it is kept at a distance of 2-3 mm from problematic gaps. The doctor always takes a 10-second pause, after which he again applies the laser beam to the pathological areas. The entire procedure takes from 15 to 30 minutes, depending on the degree of damage to the tonsils.

The choice of laser type will be determined by the quality of the damage to the tonsils:

If degenerative processes are detected in the deep layers of the tonsils, a holmium laser is used.
For surface treatment, a fiber optic laser device is used.
To seal the tonsils, they choose an infrared laser.
A carbon dioxide laser device helps reduce the volume of the tonsils.

Postoperative period and recovery after surgery - recommendations for patients

After the manipulation, as stated above, the patient is sent home. After the anesthetic stops working, severe cutting pain in the tonsils begins to bother me.

Severe pain syndrome present for the first 24 hours. During this period, you should take painkillers, which include Ketoprofen or Nimesulide.

It should be noted that, in any case, pain after lacunotomy will be an order of magnitude lower and less durable than after tonsillectomy.

After the specified period, a white film forms on the work area. Touching it, and even more so scraping it off, is strictly prohibited; it will remove itself in a week.

To minimize the risk of exacerbations, you should gargle with antiseptics. For such purposes, you can use a decoction of chamomile/calendula, or use Lugol's solution.

Among other things, the patient should adhere to the following recommendations:

Avoid visiting public places during recovery. In such places there is a high probability of contracting a cold, which can lead to a relapse of tonsillitis.
Protect yourself from hypothermia.
Eat foods that are neither hard nor hard, neither hot nor cold. Food should not be salty, spicy or sour - this will irritate the mucous membrane of the throat, causing inflammation.
Avoid weightlifting and intense physical activity. After complete recovery, you can engage in any sport you like.
Refrain from drinking alcoholic beverages and smoking tobacco.
Treat the surgical area with sprays that contain propolis and eucalyptus.

Complications of laser cauterization of tonsils and their prevention

All complications that may arise after cauterization of the tonsils with a laser can arise for two reasons:

Incompetence of the surgeon performing the manipulations. Inability to work with laser equipment can result in a burn to the tonsils. Therefore, it is very important to choose trusted doctors who have a good reputation and sufficient experience working with laser technology.
Failure to comply with recommendations in the postoperative period. Leads to recurrence of tonsillitis in the future.

According to studies, experts advise against performing lacunotomy if tonsillitis has caused serious disturbances in the functioning of the heart or other internal organs/systems.

Laser lacunotomy is a modern method of treating tonsillitis, which involves removing destroyed tonsils. Unlike traditional tonsillectomy, laser removal of tonsils is less traumatic and allows you to return to normal life within a few days. During the operation, tissues in which pathological changes are noted are cauterized. High-frequency light radiation, including carbon dioxide laser, allows the evaporation of diseased tissues. The high temperature of the laser destroys diseased cells, coagulation is observed when a dead layer is created, under which new cells that are not affected by the disease can develop. Due to this, a therapeutic effect is achieved without further disturbances in the immune system. However, cauterization is not always possible, so in some cases you have to part with the tonsils. Partial removal of tonsils is usually performed if their condition is not advanced.

Indications

The main indication for the procedure is chronic tonsillitis, which cannot be treated with conservative methods. If exacerbations of the disease occur more than 3 times a year, surgery to cauterize the tonsils is indicated.

Also, laser treatment of tonsils is carried out in the absence of results of conservative treatment at the time of acute inflammation. If a sore throat does not subside after a course of antibacterial therapy using a drug to which bacteria are sensitive, laser cauterization of the tonsils is indicated.

The development of complications is another indication for laser treatment. In such a situation, it is urgent to eliminate the pathological process in the tonsils, which is why laser therapy is used. This is the only way to prevent further development of complications and direct treatment to eliminate problems, without additional use of antibiotics.

Otolaryngologist Ivan Leskov tells whether to remove tonsils or not.

Contraindications

Laser lacunotomy of the palatine tonsils also has certain contraindications, the observance of which is necessary. It is strictly prohibited in the following cases:

the moment of exacerbation of chronic tonsillitis with the development of a violent purulent process - first the acute process is removed, and only after that cauterization is carried out. Laser therapy at this point can only be used in exceptional cases;
oncological diseases, regardless of the area of localization of the tumor;
pathologies of the pancreas, including diabetes mellitus;
heart failure due to any reason;
lung diseases, in which there is a significant decrease in the lumen of the bronchi;
kidney pathologies;
open tuberculosis;
menstruation;
skin diseases;
untreated caries;
insufficient blood clotting due to low platelet levels - despite the fact that the laser cauterizes the vessels, preventing excessive bleeding, there is always a risk of damage to the main vessel, which causes significant blood loss, which can pose a serious danger if blood clotting is insufficient;
pregnancy;
breastfeeding period;
children's age from 1 year to 10 years. Children undergo such treatment in exceptional cases for emergency indications, when other therapy is impossible, and leaving the tonsils without treatment poses a threat to life.

If contraindications are identified, the otolaryngologist selects another therapy that is acceptable in a particular condition. This can be either various conservative treatment of tonsils or traditional surgery to excise the tonsils, as, for example, in the case of cancer.

Types, advantages and disadvantages

Today, 4 types of laser treatment for tonsils are used. The choice of method depends on the degree of damage to the throat and the general condition of the patient.

Cauterization (laser destruction). The procedure uses a holmium laser. During cauterization, the scars are dissected and the foci of inflammation inside the tonsils are destroyed, as well as the lacunae are cleaned and expanded. Healthy tissues are not damaged, which minimizes the recovery period.
Ablation is used if the pathological process affects a large area of the tonsils. Using laser and fiber optics, the top layer of tissue is removed. During the procedure, the lacunae expand significantly and the process of tissue renewal begins, and after it there is a particularly strong release of purulent plugs. Complete cleansing of the tonsils is recorded after 2.5-3 months.
Tonsillotomy. This type of treatment is used for severe damage to part of the tonsil. Using an infrared laser, only the diseased area is excised. The healthy portion of the tonsil remains functional. Such partial removal is often used in childhood and adolescence to eliminate defects in the structure of the tonsils, which cause chronic tonsillitis.
Tonsillectomy. The operation is performed if the tonsil is completely destroyed and restoration of its tissue is not possible. Lymphoid tissue is completely removed by laser. The edges of the wound are baked due to the high temperature emitted by the laser. Thanks to this, the risk of wound infection during the healing process is eliminated and the recovery period is reduced.

The advantages of laser treatment of tonsils are recognized by doctors as follows:

local anesthesia - all manipulations are performed only under local anesthesia, in contrast to a standard operation, which requires general anesthesia;
speed of the operation - it takes no more than 30 minutes;
the rehabilitation period is no more than 4 days with complete removal of the tonsils;
outpatient cauterization and partial removal;
minimal or no bleeding;
reducing the risk of complications to a minimum;
prevention of damage to healthy tissue;
absence of pain after surgery after the local anesthesia wears off;
complete antiseptic by cauterizing the wound.

The positive aspects of using laser in the treatment of tonsils have made lacunotomy with its use very common.

This method of treatment has practically no disadvantages. With it, if according to indications the tonsils should not be completely removed, the risk of recurrence of sore throat remains in a few years. Also a relative disadvantage is the high cost of the operation. It can only be carried out by a highly qualified specialist, which significantly increases the price.

Carrying out the operation

Performing surgery using a laser is a low-traumatic intervention, which is why in most cases it is performed on an outpatient basis.

Preparation

Complicated preparation before the operation is not required. After her appointment, a general blood test and biochemical test are taken. A smear from the pharynx with further microscopic examination and culture on a nutrient medium may also be required. Sanitation of the oral cavity is carried out.

In the evening before surgery, in case of sleep disturbance due to anxiety, taking sedatives is indicated. Despite the fact that the laser cauterizes the wound, if necessary, if there is a slight deviation from the norm in blood clotting, the use of agents to increase clotting is indicated for two weeks before the procedure.

On the day of surgery, the last meal is possible 6 hours before the procedure, and you stop drinking water 4 hours before. It is recommended to stop smoking one day before removal of the tonsils. Brushing your teeth is mandatory. No other preparation is required.

Technique

The operation is performed with the patient in a sitting position. With complete excision of lymphoid tissue, anesthesia is carried out by injecting the surgical area with lidocaine. If cauterization is prescribed, the tonsils are lubricated with an anesthetic composition.

The manipulator, which generates the laser beam, is brought to the affected area, but it does not come into contact with it. If lesions with pathological changes are cauterized, no additional equipment is required. With complete excision, the tonsil is grabbed and held with special tweezers, then it is trimmed and completely removed. The smell of burnt meat that appears during manipulation is normal.

Postoperative period

When laser therapy on the tonsils has already been carried out, it is important to properly organize the rehabilitation period, as this will minimize the risk of negative consequences and speed up the healing of damage.

exposure to the cold;
eating hard foods;
visit to the bathhouse;
vaporization;
physical exercise;
smoking;
alcohol consumption;
scream;
eating hot and cold food.

eating pureed foods at room temperature;
rinsing with salted water adding 2 drops of iodine per glass;
throat treatment with eucalyptus and propolis sprays;
rinsing with decoctions of medicinal plants such as calendula and chamomile.

Video review of a patient who underwent surgery to remove her tonsils.

Complications and their prevention

If all medical instructions are followed, complications do not arise after the operation. In rare cases, healthy tissue may burn and bleed several days after the intervention. To prevent negative consequences, all manipulations should be performed only by a qualified specialist, and during the recovery period the patient must strictly follow all recommendations.

Attending doctor

Laser lacunotomy is performed by an otolaryngologist who has completed a special training course and has the proper qualifications.