Tonsillectomy/Adenoidectomy Overview

Tonsillectomies and adenoidectomies are common and safe procedures. As a matter of fact, tonsillectomy is the second most common pediatric surgical procedure. It is also necessary at times for this procedure to be performed on adults. A tonsillectomy and adenoidectomy can help prevent frequent sore throats and ear infections. These procedures are not always performed at the same time. Only one may be needed, sometimes both.

The tonsils are glands located in the back of the mouth on both sides of your throat. As part of the immune system, tonsils help fight infections. The adenoids are located behind the soft palate, the back, muscular section of the roof of your mouth. Adenoids also help fight infections. Behind the uvula, there is a passageway that connects the nose to the mouth. And in this passageway, the eustachian tubes connect the middle ear to the back of the nose. These tubes prevent large differences in pressure inside the ear. When your adenoids swell, they become inflamed and can cause blockage of the eustachian tubes. Blockage can cause your middle ear to become filled with pus, causing additional infection and swelling. This can even lead to hearing loss.

It’s important to be examined when you have tonsillitis because it can be dangerous if there have been five or more occurrences within one year. And when the illness is not responsive to antibiotic treatment, please see us immediately!

Additionally, if your tonsils get large enough to touch each other you probably have a serious case of tonsillectomy. Also, if there is an abscess surrounding your tonsils, you will see puss filled sacs. This is another cause for attention.

Treatment of tonsillitis and ear infections generally requires antibiotics. If left untreated, tonsillitis could damage organs in your body. A tonsillectomy is an in which the tonsils are removed. Adenoidectomy is the removal of the adenoids. The combined operation is called a T&A. Generally these surgical procedures are performed if antibiotics are unresponsive. If antibiotics do not work to eliminate tonsillitis or ear infection, a tonsillectomy and possible adenoidectomy may be performed. These surgical procedures will help you reduce the number of throat and ear infections.

Tonsillectomy and Adenoidectomy is performed under general anesthesia. Upon awakening, you will be given pain medication. Within a little while, you will be able to go home. Surgery is usually well tolerated although a sore throat is common for the first 5-10 days after surgery. Watch for bleeding. You will initially find it easiest to swallow liquids and cold desert like foods.

Patient Instructions

Please read and familiarize yourself with these instructions both BEFORE and AFTER surgery. By following them carefully, you will assist in obtaining the best possible results from your surgery. If questions arise, please contact our physicians or nurses.

PRE-OPERATIVE:

• If you experience signs or symptoms of an upper respiratory infection or other illness within five days prior to surgery, please call our office at (610) 879-0068.
• Do not take any aspirin or aspirin-containing drugs, ibuprofen or ibuprofen-containing drugs for one week prior to surgery. Examples of these include Aspergum, Darvon, Fiorinal, Norgesic, Advil, Motrin and many over-the-counter cough and cold preparations. Additionally, you should not take any nonsteroidal anti-inflammatory drugs such as Naprosyn which have a similar effect. If you are on this type of medication, please discuss this matter directly with us before stopping it.
• Do not eat or drink anything, including water, after midnight prior to surgery.
• If the patient is your child, please try to avoid demonstrations of parental anxiety. Do not be overly solicitous or protective. You may bring a pair of pajamas, a toothbrush, comb, teddy bear, etc. with you to the hospital. Remember your anxiety will be transmitted to your child. If made as pleasant as possible, future hospitalizations and experiences with doctors may be less traumatic for your child. Show a cheerful exterior, even if you are concerned.
• Your physician will provide you with prescriptions for medications to take at home following surgery. Please be prepared by filling your prescriptions prior to your surgery. Take only the medications prescribed by your physician(s).

POST-OPERATIVE:

GENERAL HOME CARE:

• Moderate pain in the ears, and slight fever are common and of no significance. A temperature over 101 degrees (orally or axillary) in a child should be brought to our attention.
• Gargles should not be attempted. Coughing, hacking and clearing of the throat should be avoided.
• Objectionable mouth odor commonly observed for several days is relieved by drinking fluids, rinsing your mouth with ice water, and chewing gum. Chloraseptic Spray three or four times daily may be used to help relieve throat discomfort.
• Laxatives or enemas may be given if needed.
• Secondary bleeding may occur on the sixth through the tenth post-operative days. Notify our office immediately if any bleeding should occur. Meanwhile, lie in bed propped up on two pillows with an ice bag on the neck. If the patient is kept quiet on the aforementioned days, there should be no problems. Appearance of white exudate is normal.
• White spots on the tonsillar area are normal and part of the healing process.
• Avoid hot showers during the post-operative period. Quick, lukewarm showers are ok.
• For three weeks after surgery, do not take any aspirin, aspirin-containing, ibuprofen or ibuprofen-containing drugs. (Please refer to list of products in Pre-Operative section above)

ACTIVITY:

• After discharge from the hospital, a child should be kept indoors with restricted activity for three days. Plan quiet time activities- puzzles, movies, etc. After the third day, the patient may be allowed outdoors on a nice day under supervision.
• It is advisable to keep the patient away from other people during the first post-operative week in order to avoid contracting infections. Other than siblings, contact with other children should not be permitted.
• During the sixth through the tenth day, scabs or membranes which form at the operative site usually come loose, and the raw surface which is left may bleed. During these three days, the patient should be kept relatively quiet and indoors. After 14 days, if there has been no problem, the patient may be allowed full freedom. However, activities should still be limited for a total of two weeks form the date of surgery.
• The child should not return to school until seen in our office. This post-operative visit will usually be scheduled about one week after surgery. If circumstances result in a later follow-up appointment, the child may return to school after eight days, provided there are no problems.

DIET:

• Adequate fluid intake during the first few post-operative days is essential. The patient should be encouraged to chew as much as possible. Chewing gum, though initially painful, will aid in reducing throat and ear pain, and minimizing scarring of the throat.
• FIRST DAY– Strained cereal, water ice, sherbet, jello, junket, custard, pudding, beef and chicken broth, cottage or cream cheese. Abundant fluids- a daily intake of eight to ten glasses (4 oz. glasses for children under 5 years; 6 oz. glasses for children ages 6 through 12; 8 oz. glasses for children 13 and older and adults) is ideal. Avoid caffeine.
• SECOND, THIRD & FOURTH DAYS– Soft foods may be added gradually- mashed potatoes, pureed vegetables, soft cereals, soft, boiled and poached eggs, and finely chopped meats.
• FIFTH DAY– Regular diet is gradually resumed but avoid crackers, toast, nuts, chips, pretzels, highly seasoned foods, acid and citrus juices until two weeks have elapsed from the day of surgery.

If you have any questions concerning your comfort or care, please contact our office at (610) 879-0068.

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