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TYPES OF SURGERIES
ADENOTONSILLECTOMY
The tonsils are two clusters of tissue located on both sides of the back of the throat. Adenoids sit high in the throat behind the nose and the roof of the mouth. Tonsils and adenoids are often removed when they become enlarged and block the upper airway, leading to breathing difficulty. They are also removed when recurrence of tonsil infections or strep throat cannot be successfully treated by antibiotics. The surgery is most often performed on children.
The procedure to remove the tonsils is called a tonsillectomy; excision of the adenoids is an adenoidectomy. Both procedures are often performed at the same time; hence the surgery is known as a tonsillectomy and adenoidectomy, or T&A.
T&A is an outpatient surgical procedure lasting between 30 and 45 minutes and performed under general anesthesia. Normally, the young patient will remain at the hospital or clinic for several hours after surgery for observation. Children with severe obstructive sleep apnea and very young children are usually admitted overnight to the hospital for close monitoring of respiratory status. An overnight stay may also be required if there are complications such as excessive bleeding, severe vomiting, or low oxygen saturation.
by American Academy of Otolaryngology - Head and Neck Surgery
SEPTOPLASTY AND TURBINOPLASTY
Surgery to correct a deviated septum is called a septoplasty. Septoplasty is most commonly performed to help relieve nasal obstruction. Sometimes, septoplasty is a necessary part of other surgical procedures like sinus surgery or nasal tumor removal.
During a septoplasty, your surgeon will attempt to straighten the cartilage and bone that have led to the septum being deviated. During the procedure, the lining (the mucosa) is first lifted off the cartilage and bone. The cartilage and bone can then be reshaped. Sometimes, portions of the cartilage and bone need to be removed. The lining is then laid back down.
Because the septal cartilage has 'memory'--it has a tendency to assume its initial shape-- the septal cartilage can sometimes bend after the surgery.
Septoplasty is a procedure that is done in the operating room under anesthesia. The procedure is typically performed under general anesthesia, but your doctor can help you decide if local anesthesia is an option for you. The procedure is typically performed on an outpatient basis. This means that patients come in and go home the same day.
You may have splints or packing inside your nose during the healing process. In some instances, there may be nothing more than dissolving stitches inside your nose. Your surgeon can let you know whether packing or splints will be placed in your nose and how long they will stay in place.
The turbinates are structures on the side wall of the inside of the nose. They project into the nasal passages as ridges of tissue. The turbinates help warm and moisturize air as it flows through the nose. The inferior turbinates can block nasal airflow when they are enlarged. The pictures below demonstrate how the inferior turbinates can block airflow when they are enlarged and touch the nasal septum.
The turbinates are made of bone and soft tissue. Either the bone or the soft tissue can become enlarged. In most patients, enlargement of the soft tissue part of the turbinate is the major problem when the turbinates become swollen. When the turbinates are large, they are called hypertrophic turbinates.
TRACHEOSTOMY
Tracheostomy is an operative procedure that creates a surgical airway in the cervical trachea. It is most often performed in patients who have had difficulty weaning off a ventilator, followed by those who have suffered trauma or a catastrophic neurologic insult. Infectious and neoplastic processes are less common in diseases that require a surgical airway.
Tracheostomy is a utilitarian surgical procedure of access; therefore, it should be discussed in light of the problem it addresses: access to the tracheobronchial tree. The trachea is a conduit between the upper airway and the lungs that delivers moist warm air and expels carbon dioxide and sputum. Failure or blockage at any point along that conduit can be most readily corrected with the provision of access for mechanical ventilators and suction equipment. In the case of upper airway obstruction, tracheostomy provides a path of low resistance for air exchange
SUPRAGLOTOPLASTY
Supraglottoplasty is a microscopic surgical procedure to alter malformed structures of the upper larynx. This allows a child with certain conditions (such as severe laryngomalacia) to breathe more easily.
This procedure is done through the mouth. A laser or surgical instruments may be used to conservatively remove obstructive tissue in the upper larynx. This surgery generally takes about one hour, and the child may or may not require a breathing tube overnight following the procedure. Photos of the airway will be taken to document the exam.
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