Tonsillectomy/adenoidectomy: Indications, Complications, Post-tonsillectomy Bleeding, Morbidity and Mortality

Palatine and nasopharyngeal tonsils are lymphatic flesh clusters of tissue of the respiratory and digestive tract’s epithelium (1). Classification by site includes palatine, lingual and pharyngeal tonsils. They have important role in the body’s immune system, once they are near the entrance to the breathing passages where incoming antigens may be aspirated or ingested (2). 1. The palatine tonsils are the lateral walls that compose the bulk of the so-called Waldeyer’s ring of lymphatic tissue (1). They are coated by non-keratinous stratified epithelium, as an extension of the oral pharyngeal tissue, including 30 deep crypts that invaginate into the parenchyma, in which lymph nodes are found with the germ centers responsible for b–lymphocyte production (3). It addition to nodes, debris of epithelial cells desquamations, alive and dead lymphocytes, as well as bacterium may be present in the crypts. In cases of acute tonsillitis, collection of pus may be observed (4). They are coated by fibrous and dense capsule, separating them from a deeper consecutive tissue (2). This type of tonsils originated from the second pair of pharyngeal pouches, where endodermis bears the covering epithelium and mesenchymal structure gives origin to the lymphoid tissue (1). Palatine tonsils has classified scheme proposed by Brodsky (5): grade O – tonsils inside the tonsillar fossa