Laser lacunotomy of the palatine tonsils video. The method of laser lacunotomy of the tonsils Who is recommended treatment of the tonsils with a laser for chronic tonsillitis

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

Chronic tonsillitis usually occurs after prolonged colds, flu, with reduced immunity. It is especially manifested 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 accumulate and multiply in the holes of the tonsils - lacunae - mainly staphylococci, which are suppressed by the immune system in a healthy state. Plus, food particles get into the tonsils, which create an additional nutrient medium for microbes. In response to the multiplication of staphylococci, the body begins to produce lymphocytes that neutralize the pathogenic microflora. As a result, a mixture of pus, food particles and microbes forms in the lacunae of the tonsils, and purulent plugs form. Since the immune system is weakened, the body cannot completely get rid of microbes, there are more traffic jams, microbes penetrate deeper into the lacunae of the tonsils. When a person recovers and immunity becomes good again, staphylococci are already finally settled in the lacunae of the tonsils and without treatment the body can no longer destroy them. The lacunae of the tonsils are regularly clogged with plugs, tonsillitis becomes chronic and remains even with good immunity and a healthy state of a person.

White plugs come out of the lacunae of the tonsils from time to time - a consequence of tonsillitis. In the summer they are almost absent, in the cold season they become more, 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, enlarged lymph nodes. In general, I have good immunity, I get colds once a year in winter, sometimes I don’t get sick at all, tonsillitis doesn’t really bother me. It's just that occasionally there are nasty traffic jams. I first noticed them about 3 years ago, I did not attach any importance to this. A year ago, I became interested in this topic and went to an otolaryngologist, they prescribed me Tonsilgon tablets, rinsing with soda and washing the lacunae of the tonsils. I went for washing a couple of times, but I did not notice any results. Washing lacunae, rinsing, tablets is a conservative method of treating tonsillitis, many doctors say that tonsillitis can be completely cured only with a laser.

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

I didn’t particularly plan to treat tonsillitis, but recently, during an examination at the ENT clinic, I strongly recommended a lacunotomy. Said it would solve the tonsillitis problem once and for all.

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

The operation itself takes about 30 minutes. and lies in the fact that with the help of 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 supposedly bloodless, but for several days I observed bruises on the tonsils, although there was no blood during the operation.

First, they gave me a couple of injections in one tonsil. It's tolerable, just slight tingling. The tonsil became numb, and the doctor proceeded to the operation. With 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 cauterization in fragments, brought the laser, held it for 15 seconds in the tonsil, then pulled it out, I took a break, after 10 seconds the laser was again in the tonsil. Unpleasant, but tolerable sensations. Smoke came out of his mouth and smelled 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 to me longer than the first, apparently, it was more 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 were numb, I could not speak properly, I made a muffled gurgling, in which the words were barely distinguishable. They were only flowers. On the way home, the anesthesia started to wear off. Hell has begun. The pain is terrible, unbearable, as if pieces of my tonsils are being cut out with a knife on the living. 100 times more painful than cauterization during surgery. A terrible nightmare, I have never had a sore throat before. The second half of the way home I cried, it was terrible pain. At home, I drank 2 sachets of Nimesil, 1 tablet of Ketorol, sprinkled it with an aerosol and went to bed, when I woke up an hour later, the pain subsided quite a bit, the gift of speech returned.

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

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

Now the tonsils have already stopped hurting, but still they have not healed yet. Now I will write about efficiency.

I don’t know how tonsillitis should go after the operation, the ENT did not really explain this to me. The fact is that three days ago I did look into my throat and cleaned out a lot of traffic jams with my wire. Maybe it's old plugs coming out that were there before the operation, or it's tissue that has died as a result of healing. I've never gotten that many plugs before. Maybe old remnants come out of the burnt lacunae. I would like, and the doctors promise that traffic jams will disappear. I would like to believe in 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 generally forget about tonsillitis. I think, sooner or later, I would have done a lacunotomy anyway. I will check in and post updates as I see them.

I decided to write a review for those who are interested in the 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 clarified the situation a little. On Aircommend I saw more reviews about the removal of the tonsils and tonsillotomy, but the removal of the tonsils, tonsillotomy and lacunotomy are three different operations, so I decided to create a separate branch.

I hope my review was helpful to you. If there are questions, ask.

UPDATE (07/08/2014)

It has been 5 weeks since laser lacunotomy.

At first, I had mixed feelings 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 gaps. It seems to me that this was due to the fact that the tonsils did not fully heal, and the laser only burns the lacunae, and if there are plugs in the depths of the lacunae, then they will not go anywhere from the laser, 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 not a few. And closer to the tongue, it was as if another lacunae of the tonsils appeared (I apparently didn’t notice them before), from which the plugs also came out (the ones that were closer to the palate burned me). This was 3 weeks after the lacunotomy.

I stocked up on chlorhexidine and cleared and washed the lacunae of the tonsils almost every day. I adapted to bring the nose of the bottle of chlorhexidine close to the gap, pressed the bottle, felt how chlorhexidine washes the gaps, and not just pours into the throat. Feelings are 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 notice that the tonsils had become clean, I again stopped noticing those second lacunae of the tonsils that had not been burned to me.

For the last 2-3 weeks, I tried to wash the lacunae of the tonsils a couple of times, but I got used to this procedure and it became very unpleasant for me, I began to twist. And during these 2-3 weeks, I never noticed traffic jams in the tonsils, although earlier they appeared 5 days after washing.

Now I do not wash the lacunae of the tonsils, and there are no traffic jams in them at all, for 2-3 weeks already. The tonsils themselves seem to have even decreased. Before, 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 didn’t get sick, but in the morning I still spoke hoarsely, there was a feeling of a lump in my throat. After the lacunotomy, the throat healed for 2 weeks, and somehow unexpectedly for myself, I noticed that I no longer wheeze in the morning.

Overall, I'm glad I did the lacunotomy. After the throat finally healed and all the accumulated plugs came out, I don’t find new plugs, the tonsils have slightly decreased, I stopped wheezing in the morning, there is no feeling of a lump in my throat. Sometimes for prevention I rinse my throat with chlorhexidine.

UPDATE 11/30/2014

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

Almost six months have passed since the lacunotomy. With the onset of the first cold weather, I caught a cold, my throat hurt. Tonsillitis almost did not manifest itself all these six months, there were very few traffic jams, but with acute respiratory infections it usually worsens. And then I caught a cold so much that my lymph nodes even enlarged and my tonsils became a little larger. Traffic jams have not disappeared anywhere, they also became a little more than usual. Not as much as it was before the lacunotomy, but the tonsils are not completely clean either. And on the tonsils, as if there were more holes, where they were burned, there are almost no traffic jams, but they appear in the lacunae, which are slightly higher. And sometimes there are unpleasant sensations, as if somewhere in the sky there are plugs 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

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

The flu did not pass me by, when many around are sick, I, of course, also got sick. The temperature rose, the throat ached, a cough appeared. Previously, an increased number of plugs in the lacunae of the tonsils was added to these symptoms.

And now ... In general, no matter how much I tried to clean the tonsils, no matter how much I wielded my specially adapted wire, I did not find a single plug. Where lacunotomy was done, now there are no traffic jams at all! I've forgotten about them for the past few months. At the same time, immunity is now lowered, in the middle of winter I easily get sick, and my tonsils are clean. I surprised myself. I did it in May, now 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 healed, in the summer I periodically removed them, in the fall there were some. And then they somehow gradually disappeared, although I did not treat them purposefully, I just gargled during a cold. Maybe the lacunotomy has such a long-term effect. I would like to hope that these plugs will no longer appear, and tonsillitis will no longer bother me.

UPDATE 07/09/2015

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

I get ARD about 2 times a year. Neither during illness, nor at the usual time, I am not disturbed by traffic jams in the lacunae of the tonsils. About a month ago it was quite a bit, so, a small dot on the surface, this is not even considered a cork. And when I try to squeeze them out as before, they are still not there. Such is the effect of the operation. In the first months there were a lot of them, but now they are not at all, although I did not additionally gargle to remove them.

Laser treatment of tonsillitis is one of the most innovative and effective means of combating chronic inflammation 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 enabling doctors to keep this part of the throat intact. All these efforts of physicians are due to the fact that the tonsils play an important role in the formation of a strong immune system of the patient, act 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 us consider in more detail 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 develops, provoked by an infectious infection. Lacunotomy using a laser beam is considered one of the least traumatic methods of surgical treatment of tonsils. Especially if the patient has a stage of exacerbation of the disease, swelling and redness of the mucous membrane of the tonsils develop.

The mechanism of the therapeutic procedure of this type is as follows:

A surgeon who has permission to perform surgical treatment using a laser and auxiliary equipment that provides a continuous stream of laser beam, injects the tonsil area with local anesthesia. This stage of tonsillitis treatment with laser therapy is the most painful. The patient must endure the introduction of an injectable anesthetic.
After the anesthesia takes effect and the patient loses sensitivity in the area of the tonsils, the surgeon proceeds to the effect of the laser beam on the surface of the tonsils.
The specialist conducts a dissection with a hot laser stream of lacunae, in which purulent plaques and a huge amount of pathogenic microflora are in excess. During the implementation of these manipulations, purulent contents, pathogenic microbes are simultaneously removed, and the doctor gets the opportunity to immediately perform cauterization of the operated throat area in order to avoid profuse blood loss.

Under the influence of high temperatures of the laser beam, thermal excision of the infected tissues occurs and the chronic focus of the 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 purely individual and depends on the age of the patient, the severity of the clinical picture of acute or chronic tonsillitis, which was diagnosed in the patient. In general, the optimal indicator for the restoration of tissues of the operated tonsils using a laser is 10 days.

Who is recommended laser treatment of tonsils for chronic tonsillitis?

Laser treatment of tonsillitis is analogous to tonsillectomy, when a bacterial infection has affected the tissues of the tonsils so much that conservative treatment using traditional medicines no longer brings the expected therapeutic effect. Therefore, before the otolaryngologist and directly the patient himself, the question arises of the complete removal of the tonsils with the help of surgical equipment, or the performance of medical manipulations with a laser, cauterization of the affected areas of the tonsils and the preservation of 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 has an exacerbation of the disease more often than 3 times a year, then this is a direct indication for performing laser sanitation of the infected areas of tonsil tissues. In the absence of this treatment, the number of exacerbations of tonsillitis will only increase every year.

Negative response to conservative treatment

Therapy of chronic and acute tonsillitis always begins with the patient undergoing a medical course of treatment, the use of potent antibacterial drugs, antiseptic solutions for rinsing the throat. If during therapy there is no positive reaction and the patient's condition does not improve, the inflamed tonsils retain their swelling, soreness, and purulent plaques continue to fill the lacunae of the tonsils, then this is a direct indication for laser therapy of tonsillitis.

Development of complications

Tonsillitis is an infectious disease that is most dangerous for the development of its complications. In the event that a patient, during a comprehensive examination or on the basis of complaints received from him about unsatisfactory health, has such diseases as infectious myocarditis, rheumatoid arthritis, paratonsillar abscess, signs of blood poisoning, the development of acquired heart disease, then with 85% probability it is possible to suggest that these pathologies were provoked precisely by the presence of a chronic or acute form of tonsillitis in the patient. The loss of precious time and the lack of therapy for tonsil tissues in the future threatens the patient with an even more acute development of complications with damage to vital organs.

If a patient with tonsillitis has the indicated comorbidities, 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

Lacunotomy not only has advantages and is highly effective in terms of affecting the tonsils affected by the infection, 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 acute phase of the development of an infectious disease with signs of profuse suppuration and the formation of multiple plaques (it is recommended to remove the inflammatory process with antibacterial drugs and only after that proceed with the lacunotomy procedure);
the development of malignant tumors in the patient's body, regardless of the type of cancer, 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 degenerate cells and then the tumor will begin to develop even more intensively);
various diseases of the pancreas, as well as type 1 and type 2 diabetes mellitus 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 airways;
too low a level of platelets in the blood, which provokes poor blood clotting, leads to frequent bleeding (lacunotomy itself is characterized by minor blood loss, since the laser not only removes the affected tissues of the tonsils, but also cauterizes them immediately, but still there is always a risk touch the main vessel and get profuse 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 life any stressful situations are categorically contraindicated for a woman, and lacunotomy is still an operation during which not a scalpel is simply used, but a hot laser beam);
children whose age is between 1 and 10 years should also not be subjected to laser therapy for chronic tonsillitis.

These are the main medical contraindications that prohibit laser excision of infected tonsil tissues, since much more dangerous complications may develop.

In the presence of these pathologies, the otolaryngologist selects other treatment methods for the patient, based on conservative therapy, or on traditional surgical intervention. 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 enough for the result?

The cost of laser therapy for tonsillitis by sanitizing diseased tonsils with 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 performs this type of treatment. On average, the price range for the cost of lacunotomy is in the range of 1200-1500 rubles for 1 procedure. In most cases, it is not possible to completely get rid of the foci of inflammation in the tonsils in just one session, and it may be necessary to undergo 2-3 laser therapy procedures. Following the completion of treatment, after 10 days, 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 with the patient's recovery.

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

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

What is laser lacunotomy, how is it different from tonsillotomy or tonsillectomy - 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, with its help the pathogenic microflora is suppressed.

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

As a result of all this, purulent plugs form in the openings of the tonsils, which become larger over time, and they penetrate deeper into the gaps. 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 gaps and have an unpleasant odor.

Lack of adequate treatment can lead to the development of serious exacerbations.

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

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

At tonsillotomy perform partial resection of the tonsils tonsillectomy- their complete removal.

Advantages of laser lacunotomy:

Absence of bleeding during the manipulation, which minimizes the risk of complications in the future. The laser beam cauterizes the gaps, thereby making the operation bloodless. In extremely rare cases, small bruises are possible in the first days after the operation.
Spot processing of the working area makes it possible to preserve healthy tissues as much as possible and eliminate pathological ones.
No need for hospitalization. Lacunotomy is performed on an outpatient basis, after which the patient is allowed to go home.
This procedure can be performed on children from 3 years.

Indications for laser treatment of tonsils

Patients need this manipulation 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 focus of infection.
Purulent plugs are permanent, and therapeutic measures cannot cope with their elimination.
Diagnosing complications in patients in the form of malfunctions of the kidneys, heart, and joints. Although this point is controversial among physicians. Some experts believe that with the development of these exacerbations, it is better to completely remove the tonsils than to treat them.
The large size of the tonsils, which adversely affects the respiratory function.

Contraindications for laser lacunotomy

This procedure may not always apply.

There are certain contraindications to it:

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

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

A few days before the manipulation in question, the patient is sent for delivery biochemical and general blood test. 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 is sanitation of the oral cavity before laser lacunotomy.

If the patient is impressionable and perceives the upcoming manipulation too close to the heart, he should drink it the day before the lacunotomy 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 need to be drunk within two weeks before the operation.

On the day of cauterization of the tonsils, it is necessary to refrain from eating, as well as brush your teeth.

The algorithm of the considered procedure is as follows:

Anesthesia. Lidocaine injections into the tonsils are often used. First, a couple of injections are made in one tonsil. After completing its cauterization - in the second.
Actually cauterization. The patient remains in a sitting position throughout the procedure. At the same time, the manipulator does not come into contact with the working area: it is held at a distance of 2-3 mm from problematic gaps. The doctor always maintains a 10-second pause, after which he again acts on the pathological areas with a laser beam. The whole procedure takes from 15 to 30 minutes, depending on the degree of damage to the tonsils.

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

If degenerative processes are fixed in the deep layers of the tonsils, a holmium laser is used.
In surface treatment, a fiber optic laser device is practiced.
For sealing the tonsils, they opt for an infrared laser.
The carbon dioxide laser device helps to reduce the volume of the tonsils.

Postoperative period and recovery after surgery - recommendations for patients

After the manipulation, as mentioned above, the patient is allowed to go home. After the anesthetic ceases to act, severe cutting pain in the tonsils begins to disturb.

Pronounced pain syndrome present for the first 24 hours. During this period, you should drink 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 prolonged than after tonsillectomy.

After the specified period, a white film forms on the working area. Touching her, and even more so - scraping, is strictly prohibited, she will eliminate herself in a week.

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

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

Avoid visiting public places at the time of recovery. In such places, there is a high probability of contracting a cold, which can lead to a recurrence of tonsillitis.
Beware of 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, provoking the appearance of inflammatory processes.
Refuse weightlifting and intense physical activity. After full recovery, you can do any kind of sport.
Refrain from drinking alcohol and smoking.
Treat the surgical area with sprays that contain propolis and eucalyptus.

Complications of laser cauterization of the tonsils and their prevention

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

The incompetence of the surgeon performing the manipulations. Inability to work with laser equipment may result in tonsil burns. Therefore, it is very important to choose trusted doctors who have a good reputation and sufficient experience with laser technology.
Non-compliance with recommendations in the postoperative period. Leads to recurrence of tonsillitis in the future.

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

Laser lacunotomy is a modern way of treating tonsillitis, in which the destroyed tonsils are removed. Unlike traditional tonsillectomy, laser tonsil removal is less traumatic and allows you to return to normal life in a few days. During the operation, tissues with pathological changes are cauterized. High-frequency light radiation, including a 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 it is necessary to part with the tonsils. Partial removal of the tonsils is usually carried out if their condition is not neglected.

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, an operation to cauterize the tonsils is indicated.

Also, laser treatment of the tonsils is carried out in the absence of the results of conservative treatment at the time of acute inflammation. If the sore throat does not recede after a course of antibiotic 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 complications and direct treatment to correct problems, without the additional use of antibiotics.

Otolaryngologist Ivan Leskov tells whether the tonsils should be removed or not.

Contraindications

Laser lacunotomy of the palatine tonsils also has certain contraindications, which must be observed. Its implementation is strictly prohibited in such cases:

the moment of exacerbation of chronic tonsillitis with the development of a violent purulent process - the acute process is first removed, and only after that cauterization is carried out. Laser therapy at this point can only be applied in exceptional cases;
oncological diseases, regardless of the area of localization of the neoplasm;
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 pathology;
tuberculosis of an open form;
menstruation;
skin diseases;
untreated caries;
insufficient blood clotting due to low platelet levels - despite the fact that the laser cauterizes the vessels, preventing heavy bleeding, there is always a risk of damage to the main vessel, in which significant blood loss occurs, which can be a serious danger in case of insufficient blood clotting;
pregnancy;
breastfeeding period;
children's age from 1 year to 10 years. Children undergo this treatment in exceptional cases in case of emergency, when other therapy is not possible, and leaving the tonsils untreated is a threat to life.

If contraindications are identified, the otolaryngologist selects a different therapy, which is acceptable in a particular condition. This can be both various conservative treatment of the tonsils, and the traditional operation to excise the tonsils, as, for example, in the case of oncological diseases.

Types, advantages and disadvantages

Today, 4 types of laser treatment of 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 cleaning and expansion of the lacunae. 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 a laser and fiber optics, the top layer of tissues is removed. During the procedure, the gaps expand significantly and the process of tissue renewal starts, and after it, a particularly strong exit of purulent plugs occurs. Complete cleansing of the tonsils is fixed 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. A healthy part of the tonsil remains functional. Such partial removal is often used in childhood and adolescence to eliminate defects in the structure of the tonsils that cause chronic tonsillitis.
Tonsillectomy. The operation is performed if the tonsil is completely destroyed and the restoration of its tissues 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. Due to this, the risk of infection of the wound during its healing is eliminated and the recovery period is reduced.

The advantages of laser treatment of tonsils by doctors are the following:

local anesthesia - all manipulations are carried out only under local anesthesia, in contrast to the standard operation, which requires general anesthesia;
the speed of the operation - it takes no more than 30 minutes;
the rehabilitation period is not more than 4 days with the complete removal of the tonsils;
outpatient cauterization and partial removal;
minimal bleeding or its complete absence;
reducing the risk of complications to a minimum;
prevention of damage to healthy tissue;
the absence of pain after the operation at the end of the action of local anesthesia;
complete antiseptic due to cauterization of the wound.

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

There are practically no disadvantages of this method of treatment. With it, if, according to the testimony of the tonsil, it is necessary to remove it incompletely, there is a risk of recurrence of tonsillitis after a few years. Also a relative disadvantage is the high cost of the operation. Only a highly qualified specialist can carry it out, which significantly increases the price.

Operation

Laser surgery 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 a biochemical one are taken. A smear from the pharynx with further microscopic examination and inoculation on a nutrient medium may also be required. The oral cavity is being rehabilitated.

In the evening before the operation, in case of sleep disturbance due to anxiety, sedatives are 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 manipulation, and drinking water is stopped 4 hours before. Smoking is recommended to stop a day before the removal of the tonsils. Teeth cleaning is required. No other preparation is required.

Technique

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

The manipulator, which generates a laser beam, is brought to the affected area, but it does not come into contact with it. If foci with pathological changes are cauterized, additional equipment is not required. With a complete excision, the tonsil is captured and held with special tweezers, then it is cut and completely removed. The smell of scorched meat that appears during manipulations is a normal phenomenon.

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 accelerate the healing of injuries.

stay in the cold;
eating hard food;
visiting the bath;
vaporization;
physical exercise;
smoking;
alcohol consumption;
cry;
taking hot and cold food.

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

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

Complications and their prevention

If all medical prescriptions are followed, there are no complications after the operation. In rare cases, it is possible to burn healthy tissues and bleed a few 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 carried out by an otolaryngologist who has completed a special training course and has the proper qualifications.