Lingual tonsillectomy with the PlasmaBlade

The most common indication for lingual tonsillectomy is lingual tonsil hypertrophy that causes sleep-disordered breathing and occasional dysphagia. A less-frequent indication is chronic lingual tonsillitis. Lingual tonsillectomy is warranted in cases where these symptoms are not alleviated with appropriate medical management. These patients are at risk for perioperative airway obstruction, and a detailed plan for airway management should be worked out with the anesthesia team before surgery. Exposure is often the most difficult part of the procedure; this can be accomplished either with suspension laryngoscopy or with a transoral endoscope. Likewise, lingual tonsil tissue can be removed in a variety of ways. Our preferred method is with coblation technology with transoral endoscopic visualization. This article reviews current concepts regarding patient evaluation, surgical technique, perioperative airway management, and potential complications.