ABOUT THE PROCEDURE

The tonsils are two pads of tissue located on either side of the back of the throat. The adenoids are a similar pad of tissue located behind the back of the nose in the throat. These pads can become enlarged in response to recurrent infections or strep throat. They can also become a reservoir for bacteria.

Most common reasons for Tonsillectomy (T) or Adenotonsillectomy (T&A):

1. Upper airway obstruction. Enlarged tonsils and/or adenoids can block the airway causing difficulty breathing.

2. Recurrent tonsil infections despite antibiotic therapy. For example, 7 episodes of tonsillitis in one year, 5 episodes per year for 2 consecutive years, or 3 episodes per year for 3 consecutive years.

3. History of peritonsillar abscess

4. Concern for malignancy

WHAT TO EXPECT

The surgery takes approximately 60 minutes. The patient remains at the hospital for 2-4 hours after outpatient surgery or overnight if admitted. Expect a fair amount of throat pain for about a week. Many patients also complain of earache. The same nerve that goes to the throat goes to the ears and stimulation of this nerve may feel like an earache. Patients may also complain of jaw and neck pain. This is from positioning in the operation room. Some patients experience nausea and vomiting from the general anesthetic. This occasionally occurs during the first 24 hours after surgery and usually resolves on its own. A low grade fever is normal for several days after surgery. Snoring and mouth breathing are normal after surgery because of swelling. Normal breathing should resume 10-14 days after surgery. A white membrane or scab will form where the tonsils were removed. The scabs are thick and white and cause bad breath. This is normal. They usually fall off 5-10 days after surgery. Expect scant blood-tinged spit for 1-2 days after surgery. If patient has profuse bleeding, contact us immediately or go directly to the emergency room.

POST-OPERATIVE CARE

Soft diet for 2 weeks. Drink plenty of fluids. Some children are reluctant to drink because of pain. Offer and encourage fluids frequently such as non-acidic juice, soft drinks, popsicles, Jell-O, pudding, yogurt and ice cream. No sharp food (including chips, crackers, taco shell, pizza crusts), straws, or hot/acidic liquids. Some patients lose weight, which is gained back when a normal diet is resumed. Take only the prescription pain medication for severe pain or Tylenol for mild pain. Pain medication should be taken around the clock for the first 2-4 days. Thereafter, it can be used every 4 hours as needed. No aspirin, ibuprofen (Advil, Motrin), or naprosyn (Aleve) should be taken.

Patients rest at home for several days after surgery. Generally, patients can return to school or work in about a week. No strenuous activities (bending, straining, lifting heavier than a phonebook, gym, physical education) for 2 weeks after surgery. Please do not travel out of town for 2 weeks after surgery.

FOLLOW-UP

Patients are usually seen in the Head & Neck Surgery Clinic within 2-3 weeks after surgery. Following surgery, you should arrange your first postoperative appointment by calling 559-448-4467.

CALL FOR ANY OF THE FOLLOWING

1. Severe pain not relieved by prescribed pain medication

2. Inability to swallow

3. Spontaneous bright red bleeding

4. Fever over 102° F

5. Severe dehydration

WHEN AND WHO TO CALL

Between 9:00 am and 5:00 pm, Monday through Friday: 559-448-4467 (Head & Neck Surgery Clinic) After 5:00 pm and on weekends: 559-448-4555 (Advice nurse)