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November 1926


Author Affiliations

Otolaryngologist to Philadelphia Hospital for Contagious Diseases; Instructor in Laryngology Graduate School, University of Pennsylvania PHILADELPHIA

Arch Otolaryngol. 1926;4(5):421-423. doi:10.1001/archotol.1926.00590010447003

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Since tonsillectomy is a necessary operation, it should be performed with the least amount of risk to the patient, and all tonsillar tissue should be removed completely. A general anesthetic undoubtedly adds considerable danger to the operation, especially in the presence of pulmonary, renal and cardiac diseases, exophthalmic goiter, diabetes, syphilis, anemia, status lymphaticus and other conditions. In addition, a general anesthetic may predispose to pneumonia, lung abscess, hemorrhage or asphyxia. Therefore, several years ago, I decided to perform a nerve block tonsillectomy. I consulted the latest authorities concerning the nerve supply to the tonsil; as I was unable to obtain this information from them, I was compelled to seek it in the dissecting room.

After making careful dissection studies, I found that the tonsil is supplied by seven nerve filaments, and that if each one of these seven filaments is anesthetized, the tonsillectomy is entirely painless; other

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