Psoriasis Improves After Tonsillectomy

Image by Bobjgalindo in Wikipedia It is felt that certain skin psoriasis conditions may improve if not completely resolve after tonsillectomy . The psoriasis could be anywhere on the body and is hypothesized to be triggered by an abnormal immunological response to streptococcus, an organism commonly found in tonsillitis as well as strep throat. The exact mechanism is unclear but several studies performed over the years found potential benefit, especially for guttate psoriasis and even t…

12/04/2016 0

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Liquid Biopsy for Head and Neck Cancer

Liquid biopsy is when a simple blood draw is performed in order to detect cancer cells (CTC) or mutated DNA fragments (ctDNA) free floating in the bloodstream that has been shed from the cancer's primary or secondary sites. This test has been heralded as an alternative way to make a diagnosis instead of an invasive surgical biopsy whether by needle or excision. Liquid biopsy has been developed mainly for detecting cancers of the breast, prostate, colon, ovarian, lung, and melanoma. Liqu…

6/05/2016 0

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Does Tonsil Removal Negatively Effect a Person's Body/Immune System?

Tonsils are basically lymph nodes that are on the surface (of the mouth) where they can be seen. Most lymph nodes are located under the skin where they can be felt, but not directly visualized. As such, tonsils are part of the body's immune system which helps to guard against infections. Indeed, tonsils are known to produce antibodies. So this begs the question of what adverse effects may result from tonsil removal ? If there are any negative effects, how severely is it impacted? What p…

6/16/2015 0

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Tonsillectomy Lawsuit Due to Taste Loss

An ENT was sued for $1.5 million dollars for normal taste loss that occurred after tonsillectomy that was performed in 2009. The jury did not find the ENT negligent, but awarded the money due to failure to obtain "informed consent." Given the patient is a restaurant owner and cook, the loss of normal taste has impacted his life tremendously. [ link ] Taste loss/alteration after tonsillectomy is an extremely rare complication... like very rare to the point where it is worth writin…

5/11/2015 0

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What is the Most Common Cause of Bacterial Sore Throat? (Hint... It is NOT Strep)

Viruses may cause the most sore throats, but when it comes to bacterial sources, strep seems to get a bad rap as THE germ that causes tonsillitis and pharyngitis. However, a 2015 study from University of Alabama suggests that group A strep which is detected by the commonly used rapid strep swab only accounts for about 10% of bacterial sore throats. The real culprit that causes most of the bad non-viral sore throats at least in young adults (15-30 years) is Fusobacterium necrophorum . Th…

5/08/2015 1

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Acupuncture Helps with Tonsillectomy Pain

Back in 2013, I blogged how acupuncture may help with pain after tonsillectomy in children [ link ]. This was based on a study by Dr. Ochi published in Dec 2013 on 56 children. Another study has been published in April 2015 on 59 children by a different group of researchers which support Dr. Ochi's findings as well as another in 2019 found acupuncture helpful in adults. Although no significant differences in the amount of opioid medications administered or total post-anesthesia care t…

4/13/2015 0

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Weight Loss After Tonsillectomy in Adults

An adult undergoing tonsillectomy experiences some of the worst pain they could potentially encounter in their lifetime. Not only that, it may last up to 3 weeks. With such pain, it is not surprising that dehydration is one of the most common risks of this surgery. Along with such pain, weight loss is a not unexpected occurrence given oral intake substantially decreases for such a long time. Typically, I've told patients around a 10 pound weight loss is not unusual, but that's just…

4/10/2015 0

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Bleeding After Tonsillectomy (Pictures)

Bleeding after Tonsillectomy (circa 2010) 5 years old patient Bleeding after tonsillectomy is a very rare, but potentially life-threatening event. The often quoted probability of bleeding after this surgery is 1 in 1000 . Many surgeons have statistics much better than this. I like to consider myself in this "better" group. But... no matter how good you are, if enough tonsillectomies are performed, statistically, a significant bleed after tonsillectomy will occur at some point no…

3/06/2015 4

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At-Home Rapid Mono Testing

Rapid mono test kits  can be purchased by anybody to be done at home which may save parents/patients money in doctor visits as well as getting an answer right away. Indeed, should mono testing be positive, than you know that the patient is contagious... and that there's not much to do other than give it time to resolve. A doctor visit may still be worthwhile since there are other possible causes of a sore throat including strep throat, cancer ,  aphthous ulcer ,  sinus infection ,  reflux …

1/24/2015 1

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Tonsillectomy "May" Help with PANDAS?

Only in kids, there is a VERY rare (and controversial) disorder where strep throat infections can rapidly lead to involuntary tics including  chronic throat clearing ,  cough , head/neck movements, sneeze, etc as well as OCD behavior. Known as PANDAS ( P ediatric A utoimmune N europsychiatric D isorder A ssociated with S treptococcus), it is felt to be an autoimmune reaction triggered by antibodies produced by the body when fighting a strep infection. With this disorder, an evaluation with…

1/10/2015 1

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New Video on Tonsillectomy and Adenoidectomy (Re-mastered and in HD)

Back in 2007, I uploaded a video on tonsillectomy and adenoidectomy which may have been cutting age at the time, but much has changed in the YouTube world including the usage of high definition and wide-screen format. I also purchased a new microphone since than so narration does not quite sound like I'm yelling all the time. You can watch the "old" version tonsillectomy and adenoidectomy . And here are the two new videos refreshed for 2012 that have been remastered and in HD…

9/22/2014 0

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Steroids Helpful After Tonsillectomy?

Pain is perhaps the most common dreaded fear patients have when considering tonsillectomy surgery.  After pain, bleeding is perhaps the 2nd greatest concern patients have. With both these issues, steroids play a key role by helping with one at the expense of the other. In the 2011 Clinical Practice Guideline: Tonsillectomy in Children , the authors strongly recommend giving a single large dose of steroids to help with not just pain, but also nausea and vomiting after surgery. It is not jus…

9/20/2014 0

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Hole in Tonsil Area After Tonsillectomy

Rarely, a patient may notice a hole in the mucosa in the area where the tonsil used to be after removal ( tonsillectomy ). This hole typically is located in the anterior tonsil pillar as shown in the picture to the right. Less commonly, the hole may occur on the posterior tonsil pillar as shown below. Typically, this hole appears not immediately after surgery, but 5-10 days afterwards. Known as a fistula, this is a temporary situation as this hole will almost always close up over several …

8/22/2014 1

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Acupuncture Alleviates Pain After Tonsillectomy in Children

The study showed that acupuncture significantly decreased pain after tonsillectomy in children (2-17 years of age) with reported pain levels before acupuncture of 5.52 (SD=2.28) out of 10 which fell to 1.92 (SD=2.43) after acupuncture. This retrospective research was conducted in 31 patients who underwent a tonsillectomy within a 3 month period of time by Dr. James Ochi , one of only a handful of dual board-certified ENT and medical acupuncture in the United States. No study patients rece…

12/14/2013 0

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At-Home Rapid Strep Testing

Rapid strep test kits can be purchased by anybody to be done at home which may save parents/patients a lot of money in doctor visits for those prone to strep infections . Indeed, should a rapid strep test be positive, than you know that a doctor's visit is definitely worthwhile. (A doctor visit may still be worthwhile since a sore throat may be due to something else like cancer , aphthous ulcer , sinus infection , reflux , etc). Such home kits (which in fact are the same kits used in medi…

11/16/2013 0

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Did a Case of Lemierre's Syndrome Influence Super Bowl XLVII?

Image by Keith Allison from Wikipedia Lemierre's syndrome is an exceedingly rare complication of tonsillitis characterized by an infected clot of the jugular vein leading to sepsis. It may also have potentially influenced Super Bowl XLVII due to an interesting quirk in history. Back in 2008, a former Heisman Trophy winner from Ohio State University named Troy Smith was the quarterback for the Baltimore Ravens. Great things were expected of him as he was gearing up to start in th…

9/11/2013 0

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PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus)

Only in kids, there is a VERY rare (and controversial) disorder where strep throat infections can rapidly lead to involuntary tics including chronic throat clearing , cough , head/neck movements, sneeze, etc as well as OCD behavior. Known as PANDAS  ( P ediatric A utoimmune N europsychiatric D isorder A ssociated with S treptococcus), it is felt to be an autoimmune reaction triggered by antibodies produced by the body when fighting a strep infection. With this disorder, an evaluation with a p…

7/12/2013 0

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New Video on Awake Tonsil Cryptolysis to Address Tonsil Stones

A  new video  has been uploaded describing a minimally invasive technique to address tonsil stones called  tonsil cryptolysis . This technique accomplishes the same thing as laser cryptolysis but at lower cost and increased safety. Just like laser cryptolysis, this procedure can be done awake without any sedation using only local anesthesia (the caveat being that the patient must have minimal/no gag reflex with easy visualization of the tonsils). Watch the video below or on  YouTube . Read…

5/30/2013 0

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17 Year Old Girl Dies After Tonsillectomy

Patients sometimes focus too much on the intricacies and risks of the surgery itself and not realize that subsequent care AFTER surgery may be just as important and risk-laden. Media reported yesterday about the tragic death of a 17 year old girl after tonsillectomy . Apparently in March 2012, the Pennsylvania teenager underwent a routine tonsillectomy without any problems. While in recovery after surgery (PACU), she was given fentanyl, a powerful narcotic to help with pain, but als…

2/06/2013 0

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Speech Impediment to Great Singing on American Idol

During January 2013 auditions of Season 12 of American Idol, there was Lazaro Arbos who has a terrible stutter when he talks, but sings beautifully. A week later, we encountered Micah Johnson  who also suffers from a speech impediment, but rather than a stutter, it was due to "nerve damage" sustained during a tonsillectomy . (Watch videos below) With stuttering, the problem mainly lies at the brain level. The brain coordinates how a person uses all of their throat muscles to crea…

2/01/2013 3

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