Te tango i te tonsillectomy coblation: Te maimoatanga, ngā painga, me te whakaora

He mea noa ngā raruraru o ngā pūngāwerewere, inā koa i roto i ngā tamariki, engari ka pāngia hoki ngā pakeke. Ko ngā mate korokoro e hokihoki mai ana, te nui haere tonu o ngā pūngāwerewere, me ngā uauatanga manawa i te wā e moe ana, ko ētahi o ngā take ka arotakehia ai e te tohunga taringa, ihu me te korokoro (ENT) te hiahia mō te pokanga.

Ko te tango i ngā tonsill coblation tētahi o ngā tikanga pokanga maha e whakamahia ana hei tango i ngā tonsil. Ka taea te whakaaro ina whakaū te tohunga ENT i tētahi tohu mārama, pērā i te tonsill kua tuhia anō, te manawa moe-aukati, te whēwhe peritonsillar anō, te whakanui rānei i te tonsil. Ka whakamahia e te coblation tonsillectomy te pūngao auau irirangi, ā, kua hangaia hei whakaiti i te whara e pā ana ki te wera ki ngā hanganga e karapoti ana, ki te whakataurite ki ētahi tikanga tuku iho.

Ehara i te mea ko ngā korokoro mamae katoa, ko ngā tonsil nui rānei e hiahiatia ana he pokanga. Ko te whakatau ka whakawhirinaki ki te kaha o ngā tohu, te auau, te tuhinga, te pānga ki te oranga o ia rā, ngā tohu manawa, ngā kitenga whakamātautau, me te tau me te āhua hauora o te tūroro. E whakamārama ana tēnei tuhinga i te wā e tohutohuhia ana te tango i ngā tonsil, me pēhea te mahi a te coblation, ngā mea hei tumanakohia mai i te tikanga, me te āhua o te haere whakamua o te whakaoranga.
 

He aha ngā Tonsils, ā, he aha i raru ai rātou?

Ko ngā tonsil he kiko lymphoid iti e rua kei muri o te korokoro. He wāhanga rātou o te pūnaha ārai mate, ā, ka āwhina i te kite i ngā huakita e tomo ana mā te waha me te ihu, inā koa i te tamarikitanga. Mō te nuinga o te hunga hauora, ko te tango i ngā tonsils kāore e puta he ngoikore roa o te ārai mate nā te mea he maha atu ngā kiko ārai mate e mahi tonu ana.

Heoi anō, ka taea e ngā tonsil te noho hei pūtake o ngā raruraru tonu ina:

• Te pangia pinepine (te mate tonsillitis auau)
• He nui haere tonu, ā, ka ārai i te manawa, i te horomi rānei
• Kua nui rawa te rahi hei aukati i te ara manawa
• He hononga ki te whēwhe peritonsillar e hokihoki mai ana
• He hononga ki te kohikohinga o ngā paru e arahi ana ki te manawa kino
• He āhua kore taurite, he āhua whakapae rānei (ina koa i roto i ngā pakeke)

Ahakoa te kore pokanga, ka taea te whakahaere i ngā kōhatu o ngā tonsil me te manawa haunga mō te nuinga o ngā tūroro; ka whakaarohia te tango i te tonsillectomy mēnā he roa, he uaua hoki ngā tohu, ā, kua arotakehia e te tohunga.

Ehara i te mea me puta ngā tonsil i ngā mamae katoa o te korokoro. Inaa, e whakanui ana ngā aratohu me tirotiro tuatahi te nuinga o ngā tamariki e pāngia ana e ngā tohumate o te korokoro, ina koa ka kore te maha me te kaha o ngā wā e tutuki i ngā paepae kua whakaaetia mō te pokanga.
 

Āhea te wā e taunakitia ai te tango i te tonsillectomy?

E rua ngā take whānui e whakaarohia ana te tango i te tonsillectomy:

1. Ngā mate urutā e hokihoki mai ana

Tērā pea ka tūtohutia te pokanga ina he maha ngā mate korokoro, he nui te pānga haumanu, kua tuhia, kua rongoatia pai, ā, e whakararuraru ana i te kura, te mahi, te moe, te kai, me te oranga o ia rā. Ko ngā paepae haumanu e whakamahia whānuitia ana ko:

• 7, neke atu rānei ngā wāhanga i roto i te tau kotahi
• 5, neke atu rānei ngā wāhanga i ia tau mō ngā tau e 2 karapīpiti
• 3, neke atu rānei ngā wāhanga i ia tau mō ngā tau e 3 karapīpiti

Mō ngā tamariki, ko ngā tohu kei roto pea i ngā tuhinga ko ngā āhuatanga pēnei i te kirika, te nui haere o ngā repe kaki, te puta o te pupuhi/te wai o te tonsillar, te kitea rānei he pai te whakamātautau streptococcal rōpū A mēnā e tika ana.

Mena he iti ake te auau o ngā pangia, he pai ake te tirotiro marie (te tatari mataara).
 

2. Te aukati i te ara manawa

Ka taea e ngā tonsils kua whakanuia te whakawhāiti i te ara manawa, ā, ka arahi ki:

• ngongoro
• Manawa manawa
• Te moe kore okioki, te moe kounga kore rānei
• Te apnea moenga moe
• I kite i ngā okiokinga manawa
• Te hiamoe i te awatea, ngā āwangawanga whanonga, te kore aro, ngā raruraru tipu rānei

Mō ngā tamariki, ka pā pea tēnei ki te whanonga, te arotahi, me te tipu. I roto i ēnei āhuatanga, ka taea e te pokanga te whakapai ake i ngā tohu me te kounga o te oranga. Heoi, ka mau tonu, ka puta anō rānei ngā tohu o te moe ārai i roto i ētahi tūroro, ā, me tirotirohia anō pea.

Ko etahi atu tohu ko:

• Te whēwhe peritonsillar e hokihoki ana
• He uaua nui ki te horomi nā te nui haere o ngā tonsils
• Te whakanui whakapae i te tonsil kotahi-taha, inā koa i roto i ngā pakeke, e hiahia ana kia tere te arotake i te ENT
   

He aha te Pokanga Tonsil Coblation?

Ko te tikanga o te "coblation" ko te "controlled ablation". I roto i tēnei tikanga, ka haere te kaha o te auau irirangi mā te tote (he otinga tote i roto i te wai) hei hanga i tētahi mara plasma e tango ana i te kiko o te tonsil i ngā pāmahana iti iho i te electrocautery paerewa.

Mā tēnei ka taea e te taote pokanga te:

• Tangohia te kiko o te tonsil
• Whakahaerehia te toto i te wā o te tukanga
• Mahi i ngā pāmahana iti iho i te hikohiko tuku iho

Ko te whāinga he whakaiti i te whara e pā ana ki te wera ki ngā kiko e karapoti ana. Heoi, kāore tēnei e whakakore i te mamae i muri i te pokanga, i ētahi atu mōrearea rānei e pā ana ki te pokanga.

E rua ngā huarahi whānui e taea ai te whakamahi i te coblation:

• Te tango i ngā tonsillectomy extracapsular: te tango katoa i te tonsil me te capsule
• Te tango i te tonsillectomy intracapsular/tonsillotomy: te tango i te nuinga o ngā kiko o te tonsil me te waiho i tētahi paparanga angiangi ki runga i te uaua korokoro. Tērā pea ka whakaitihia te mamae me te toto i roto i ētahi tūroro engari he iti noa te mōrearea o te tipu anō, o te hoki anō rānei o ngā tohu.
• Ko ngā huarahi intracapsular he mea nui ake te whakaarohia mō ngā tohu ārai i te mate urutā i roto i ētahi tūroro kua tohua.

Ko te tikanga tika e whakawhirinaki ana ki te tau o te tūroro, te tohu mō te pokanga, te rahi o te tonsil, te hiahia o te taote pokanga, me te mea he pai ake te tango katoa, te tango wāhanga rānei.
 

He aha te rerekētanga o te Coblation mai i te tonsillectomy tuku iho?

Ka taea te mahi pokanga tonsil tuku iho mā te whakamahi i te wetewete maitai makariri, te electrocautery, te bipolar diathermy, ngā tikanga microdebrider, me ētahi atu hangarau rānei. Ko te coblation tētahi o ngā kōwhiringa maha.

Ko te tino take e kukume ana i te aro, nā te mea ka taea e ia te tuku:

• He iti ake te horapa o te wera ki ngā kiko e karapoti ana, ki te whakaritea ki ētahi tikanga e ahu mai ana i te wera
• I roto i ētahi rangahau, i whakaitihia te mamae wawe i muri i te mahi
• He iti ake te ngaronga toto i te wā e pokanga ana i ētahi whakatauritenga
• Te tere ake o te hokinga ki te kai noa, ki te mahi noa rānei mō ētahi tūroro

Heoi, he rerekē ngā putanga. E kī ana ētahi rangahau he iti ake te mamae wawe, he tere ake rānei te hoki ki te horomitanga ā-waha i roto i ētahi tūroro, inā koa me ngā tikanga intracapsular, engari kāore he tikanga e tino pai ana mō ia tūroro. Ko te toto tonu te raruraru nui rawa atu i muri i tētahi pokanga tonsil. Ko ngā putanga pokanga e whakawhirinaki ana ki ngā āhuatanga maha, tae atu ki te āhua o te tūroro, te tau, me te wheako o te taote pokanga.
 

Ngā Hua o te Coblation Tonsillectomy

Mō te tūroro tika, he maha ngā painga mahi a te coblation.

1. Te tango kiko whakahaeretia me te horapa wera iti

Nā te mea he whakahaeretia te mahi a te tikanga, ka taea e ngā taote pokanga te tango i te kiko me te whakaiti i te kino kore e tika ki ngā hanganga tata.
 

2. He iti ake pea te mamae i muri i te pokanga

E whakaatu ana ētahi rangahau whakatairite me ngā arotake he iti ake ngā kaute mamae, inā koa i te wā tōmua o te whakaoranga, ki te whakataurite ki te whakamahi hiko, ki ētahi tikanga tuku iho rānei.
 

3. He iti ake te whara wera

He iti iho te pāmahana o te mahi coblation i ngā tikanga cautery paerewa. Heoi, ehara i te mea kāore he mamae o te tikanga.
 

4. Te tere ake o te whakaoranga mahi i roto i ētahi tūroro

E kī ana ētahi rangahau he tere ake te hoki ki te kai ā-waha, ki te kura, ki ngā mahi o ia rā rānei, inā koa me ngā tikanga whakakotahitanga intracapsular.
 

5. He whai hua i roto i te mahi ENT tamariki

He maha ngā wā e pā ana te pokanga o ngā tōngāmimi ki ngā tamariki, heoi, ka whai hua anō hoki ngā pakeke ina kaha te tohu. Ko te tikanga ka nui ake te mamae o ngā pakeke i muri i te pokanga, ā, ka roa ake te ora i ngā tamariki, ahakoa te tikanga, nō reira me whai whakaaro pono ki te tohutohu.
 

Ngā Here o te Coblation Tonsillectomy

He pokanga tonu te coblation. Me whai whakamoe whānui, he whakangungu mō te whakamahi i te pokanga, me te aroturuki tika i muri i te pokanga.

• Ka taea tonu te whakararu i te mamae i muri i te mahi
• Ko te toto tonu te raruraru nui rawa atu
• Ka puta te toto i muri tonu i te pokanga, i muri rānei i ētahi rā
• E rua wiki pea te roa o te whakaoranga
• Tērā pea ka roa ake te whakaoranga mō ngā pakeke

I roto i ngā tikanga intracapsular, he iti noa te kiko o te tonsil e toe ana, nō reira, tera pea ka kitea anō he tipu anō onge, he tohumate anō rānei i ētahi wā.

Kāore i te tika te pokanga intracapsular mēnā kei te whakapaetia he mate pukupuku, mēnā rānei me tango katoa te kiko. Kaua ngā tūroro e whakaaro ka whakakorea katoatia te mōrearea e te hangarau hou. He maha ngā raruraru kua mōhiotia mō te tango i te tonsillectomy, tae atu ki te toto, te matewai, te mōrearea o te rongoā whakamoe, ngā āwangawanga mate, me ngā raruraru e pā ana ki te manawa i muri tonu i te pokanga.
 

He aha ngā mea ka tū i mua i te tango i te tonsillectomy?

I mua i te pokanga, ka tangohia e te tohunga ENT he hītori taipitopito, ā, ka tirohia te korokoro, te ihu, ngā taringa, me ngā tohu e pā ana ki te moe. Ka whakaū anō hoki te tohunga ENT mēnā ko te tohu mō te pokanga he mate urutā, he tohu ārai, he raruraru ara manawa, he whakapae rānei mō te mate pukupuku.

Ko te whakarite i mua i te pokanga ko:

• Arotake i te auau me te kaha o ngā mate pukupuku tonsil
• Te tuhi i te pānga o ngā tohu ki te kura, ki te mahi, ki te moe, ki te kai, ki te oranga o ia rā rānei
• Hītori rongoā, inā koa ko ngā rongoā whakaheke toto
• Arotake i te aspirin, ngā NSAID, ngā tāpiringa, me te hītori toto
• Hītori mate pāwera me te mate whakamoe
• He rangahau moe i roto i ētahi tamariki kua tohua, inā koa ko ngā tamariki nohinohi rawa, te momona, ngā mate angaanga, ngā mate uaua-io rānei, te mate Down, ngā tohu kino, te koretake rānei mō te tautuhi mate.
• Ngā tohutohu nohopuku i mua i te pokanga
• Te kōrero mō ngā huarahi kē atu, ngā painga, ngā mōrearea, te mahere whakahaere mamae, ngā ārai toto, ngā tumanakohanga whakaora, me te wā e rapu āwhina hauora tere ai.

Ko te tikanga, me karo ngā tūroro i ētahi rongoā i mua i te pokanga mēnā ka piki ake te mōrearea o te toto, ahakoa me ārahi tonu tēnei e te tākuta e rongoā ana.
 

He aha ngā mea ka tupu i te wā e tangohia ai te tonsillectomy?

Ka mahia te tango i te tonsillectomy coblation i roto i te whare pokanga i raro i te mate whakamoe whānui, kia moe ai te tūroro, ā, kāore e mamae i te wā e mahia ana.

Ka uru atu te taote pokanga ki ngā tonsil mā te waha, kia kore ai he motu o waho i te kiri.

Mā te whakamahi i te tokotoko coblation, ka wehea e te taote pokanga te kiko o te tonsil me te whakahaere anō i te toto.

Ka rerekē te roa o te pokanga i runga i te hanganga tinana, te tikanga pokanga, te toto, me te mahi adenoidectomy, tetahi atu tikanga rānei.

I te nuinga o te wā he tikanga tiaki tamariki tēnei, arā, ka hoki te tūroro ki te kāinga i taua rā anō. Heoi anō, me tirotiro tonu pea te tūroro i te pō mō ngā tamariki nohinohi, te nui o te mate moe ārai, te momona, te mate e pā tahi ana, ngā āwangawanga mō te rongoā whakamoe, te kore e kai pai, te mōrearea rānei o te toto.

Mena he āhua whakapae, he āhua kore ōrite rānei te āhua o te tonsil, ka tukuna pea he kiko hei aromatawai i te histopathology.
 

Te Whakaora i muri i te Coblation Tonsillectomy

Ko te whakaoranga tētahi o ngā wāhanga tino nui o te haerenga a te tūroro.

Ko ngā raruraru noa o te whakaoranga i muri i te pokanga ko:

• Mamae korokoro (he nui te mamae i ētahi wā)
• Te mamae e horapa ana ki ngā taringa
• Te ngakau ki te horomia
• Te toenga kai
• He kino kino
• He mā, he kōwhai rānei ngā wāhi whakaora i roto i te korokoro

Ka kino haere pea te mamae i ngā rā 4–7 i mua i te pai haere haere.
 

Te wā whakaora noa:

• Ngā haora tuatahi 24–48: te hiamoe, te mamae o te korokoro, te uaua ki te horomi
• Ngā Rā 3–7: ka kino ake pea te mamae, ka uaua tonu pea te kai
• Ngā Rā 5–10: he mea nui tonu te mōrearea o te toto i te mea ka wetekina te kiko e ora ana
• Ngā rā 7–14: ka haere tonu te whakaora; ka wetekina ngā pāpaka; he mea nui tonu te mōrearea o te toto
• I te rua wiki: he maha ngā tūroro kua pai ake, ahakoa ka roa ake te whakamarie katoa mō ētahi pakeke
   

Ngā mahi whakaora āwhina

• Tangohia ngā rongoā mamae kua tohua i ia wā, i ia wā
• Whakamahia te paracetamol/acetaminophen me te ibuprofen mēnā kua tohua e te tākuta
• Kaua e hoatu ngā rongoā kei roto he codeine ki ngā tamariki nohinohi i muri i te tango i te tonsill.
• Āta karohia te aspirin mēnā kāore i te tohua kia tika
• Inu kia nui te wai
• Whakatenatenahia te inu wai i ngā wā katoa nā te mea ka nui ake te mamae me te toto i te wā e matewai ana
• Kai i ngā kai ngawari, i ngā kai noa rānei e whakaaetia ana, kaua e whakamomori i te korokoro
• Āta karohia ngā kai mārō, taratara, kakara, whakapataritari rānei mēnā he mamae
• Okioki, engari me tīmata anō i ngā mahi mā te āta haere
• Āta karohia te pānga ki te momi hikareti
• Āta karohia ngā mahi uaua, ngā tākaro taikaha, ngā haerenga atu rānei i te wāhi tiaki hauora i te wā e nui ake ai te mōrearea o te toto
• Whāia ngā tohutohu a te taote pokanga mō te hokinga ki te kura, ki te mahi rānei, arā, he 10–14 ngā rā te roa.
   

He aha ngā tohu whakatūpato i muri i te pokanga tonsil?

Ko te tohu whakatūpato nui ko te toto mai i te waha, i te korokoro rānei. Ahakoa he iti noa te toto whero hou i muri i te tango i te tonsill, me tere te aro ki te hauora nā te mea ka tere te kino o te toto. Koinei tētahi o ngā raruraru matua e kōrerohia ana e ngā tākuta i mua i te pokanga.

Rapua he awhina hauora tere mēnā kei reira:

• Te toto hou mai i te waha, i te korokoro rānei
• Te tuwha toto tonu
• Te ruaki toto me ngā totoka pouri
• Te ngana kaha
• Te manawa haruru, te pupuhi nui haere rānei o te korokoro
• Te matewai nui, te kore rānei e taea te inu
• Ngā tohu o te matewai pērā i te iti o te mimi, te waha maroke, te ngenge, te kore rānei o ngā roimata i roto i ngā tamariki nohinohi
• Te kirika tonu, ina koa ka haere tahi me te mamae nui haere, te kore kai pai, te toto rānei
• Te hiamoe nui, te mamae āwangawanga rānei kāore e taea te whakahaere e ngā rongoā kua tohua

Me whakaaro tonu ki te toto hou i muri i te tango i te tonsill sebagai mea ohorere.
 

Ngā Tūponotanga me ngā Pōrearea o te Coblation Tonsillectomy

Kāore he mahi pokanga e oti ana me te kore he whakamārama taurite mō te mōrearea. Ko ngā mōrearea matua o te tango i te tonsillectomy ko:

• Te tauhohenga ki te rehu
• Te toto i te wā o te pokanga, i muri rānei i te pokanga
• Te toto i roto i ngā haora 24 tuatahi, i ētahi rā rānei i muri mai
• Te mamae me te koretake o te kai ā-waha
• maroketanga
• Te pupuhi e pā ana ki te manawa i te wā tonu i muri i te pokanga
• Te wero me te ruaki
• Te huringa reo rangitahi, te mamae rānei i te horomitanga
• Te mamae/whara o ngā niho, ngutu, arero, kauae rānei i ngā taputapu waha
• Ka pā mai pea te mate, engari kāore i te tūtohutia kia whakamahia ngā paturopi auau i muri i te pokanga mō ngā tūroro katoa.
• He onge te hiahia ki te hoki ki te whare rongoā hei whakahaere i te toto
• He onge te hiahia kia whakaurua anō ki te hōhipera

Ko te rongo pai, he mahi noa te tango i te tonsillectomy, te tango i te tonsillopathy, ā, he haumaru te nuinga o te wā ki te mahi tika. Engari me whakaute tonu, inā koa ki ngā pakeke, e kī ana he uaua ake te whakaora i a rātou i ngā tamariki.
 

Ko wai kāore pea e tika ana kia tere te mahi pokanga?

Tērā pea ka whakaroahia, ka whakaarohia anō rānei te pokanga tonsil coblation mō te hunga whai:

• Kāore he tohu haumanu mārama mō te pokanga
• Te mate urutā i te wā kua whakaritea mō te pokanga
• Ngā mate toto kāore i te tino whakahaerehia
• Te whakamahinga tata nei o ngā rongoā whakaheke toto kāore e taea te whakahaere haumaru
• Ngā mōrearea o ētahi rongoā whakangote
• He mate hauora kāore i te whakahaeretia, he matewai nui rānei
• Kāore i te rawaka te tohu mō te pokanga
• He iti ake ngā mate i ngā paepae aratohu kua whakaaetia, kāore he raruraru nui
• Me whai atu i te moe, te ara manawa, te aromatawai matepukupuku rānei i mua i te whakamahere pokanga

Ehara te whakanui whakapae i te tonsil kotahi te taha i te take hei whakaroa i te aromatawai, ā, me tere te aromatawai i te ENT. Koia te take he mea nui te aromatawai i te ENT. Ehara i te mea ko ngā tonsil katoa e nui haere ana, e maha ana rānei te mumura e hiahiatia ana he pokanga.
 

Ka ngoikore te ārai mate mā te tango i ngā tonsils?

He āwangawanga noa tēnei. He wāhanga ngā tonsil o te pūnaha ārai mate, inā koa i te tamarikitanga, engari he wāhanga noa iho rātou o tētahi whatunga ārai mate nui ake. Mō te hunga hauora, kāore te tango tonsil i te nuinga o te wā ka puta he ngoikore ārai mate whai tikanga mō te wā roa.

Ka tūtohutia te pokanga mēnā ko ngā painga e tumanakohia ana, pērā i te iti o ngā mate kino, te pai ake rānei o te manawa i te wā e moe ana, ka nui ake i ngā mōrearea. Me aromatawai takitahi ngā tamariki, ngā pakeke rānei he mate ārai mate.
 

Nga Takea Matua

• E taunakitia ana te tango i te tonsillectomy i roto i ētahi kēhi, ko te nuinga o te wā mō te tonsillitis e hokihoki mai ana, e ngoikore ana te tinana, ngā tohu ārai pērā i te ngongoro me te manawa moe kore, te whēwhe peritonsillar e hokihoki mai ana, te whakanui rānei i te tonsil.
• Kāore e hiahiatia he pokanga mō ngā korokoro mamae katoa. He maha ngā tūroro ka taea te whakahaere mā te tirotiro me te maimoatanga hauora, ā, ko ngā whakataunga ka ahu mai i te auau, te kaha, me te tuhi i ngā wā o te mate.
• Ko te tango i te tonsillectomy coblation tētahi o ngā tikanga maha e whakamahia ana mō te tango i te tonsil, ā, e whakamahi ana i te pūngao auau irirangi i ngā pāmahana iti iho i te whakataurite ki te electrocautery tuku iho.
• E ai ki ētahi rangahau, ko te whakakotahitanga o te mahi tahi me te tākuta he mea e whakaiti ana i te mamae i muri i te pokanga, ā, ka tere ake te hoki ki ngā mahi o ia rā i roto i ētahi tūroro, ahakoa ka rerekē pea ngā putanga.
• Ehara i te mea ko te coblation te mea pai rawa atu i ngā wā katoa, ā, ko te whiriwhiri i te tikanga e whakawhirinaki ana ki te tūroro, te tohu, me te wheako o te taote pokanga.
• Tērā pea ka whakaitihia te mamae me te toto e te tango i ngā tonsils intracapsular i roto i ētahi tūroro engari ka mahue iho he iti noa te kiko o te tonsils, ā, he iti nei te mōrearea o te tupu anō, o te hoki anō rānei o ngā tohumate.
• Ko te tango i te tonsillectomy ka mahia i raro i te mate whakamoe whānui, ā, he maha ngā wā he noho poto noa iho, he mahi tiaki rā rānei. E whitu ki te 14 ngā rā e ora ai, ā, ka kaha ake pea te mamae i mua i te pai haere.
• Ko te toto te raruraru nui rawa atu, ā, ka puta pea i ētahi rā i muri i te pokanga. Me tere te rapu awhina hauora mēnā he toto hou mai i te waha, i te korokoro rānei.
• Kāore i te tūtohutia kia whakamahia ngā paturopi auau i muri i te tango i te tonsillll mō ngā tamariki katoa.
• Kaua e whakamahia ngā rongoā kei roto te codeine ki ngā tamariki nohinohi whai muri i te tango i te tonsillectomy.
• Tērā pea ka mau tonu, ka puta anō rānei ngā tohumate o te korenga o te manawa i roto i ētahi tūroro, ā, me tirotirohia anō pea rātou.
• Ahakoa te tango i ngā tonsils, kāore e tino ngoikore te pūnaha ārai mate mō te hunga hauora, ā, me whiriwhiri takitahi ngā whiringa maimoatanga.