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ENT Surgery


Tonsillectomy


Tonsillectomy and adenoidectomy introduction

Your doctor has recommended a tonsillectomy and/or adenoidectomy for you, a loved one, or your child. The following information is provided to help individuals prepare for surgery, and to help those involved understand more clearly the associated benefits, risks, and complications. Patients or caregivers are encouraged to ask the doctor any questions they feel necessary to help better understand the above procedure.

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The tonsils and adenoids are masses of immune cells commonly found in lymph glands (lymphoid tissue). These tissues are located in the mouth and behind the nasal passages, respectively. Infected or enlarged tonsils may cause chronic or recurrent sore throat, bad breath, dental malocclusion, abscess, upper airway obstruction causing difficulty with swallowing, snoring, or sleep apnea. Infected adenoids may become enlarged, obstruct breathing, cause ear infections or other problems. Tonsillectomy and adenoidectomy are surgical procedures performed to remove the tonsils and adenoids.

These instructions are designed to help you, a loved one, or your child recover from surgery as easily as possible. Taking care of yourself the individual having surgery can prevent complications. The doctor will be happy to answer any questions that you or the person having surgery has regarding this material. If you or your loved one, or child is having ear tube surgery (myringotomies and tympanostomy tubes placed) in conjunction with his/her tonsillectomy and adenoidectomy, please read information on these procedures as well.


Why the Procedure is Performed ?

The tonsils help protect against infections. But children with large tonsils may have many sore throats and ear infections.

You and your child’s doctor may consider a tonsillectomy if:

  • Your child has infections often (seven or more times in 1 year, or five or more times over 2 years).
  • Your child misses a lot of school.
  • Your child has trouble breathing.
  • Your child has abscess or growth on their tonsils.



Treatment for tonsillitis and adenoiditis:

Specific treatment for tonsillitis and adenoiditis will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • extent of the infection
  • type of infection
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the infection
  • your opinion or preference
Your child's physician will decide the best treatment for your child. Treatment depends on the cause of the infection, the severity of the infection, and the number of times the child has developed infections. Your child's physician may order antibiotics to help with the infection.

Some children may be referred to an ear, nose, and throat surgeon to have the tonsils and adenoids removed. This surgery is called a tonsillectomy and adenoidectomy (T&A). Often, the tonsils and adenoids are removed at the same time, but, sometimes, only one is removed. Your child's physician will discuss this with you.


What should we expect after surgery?

As previously mentioned, most patients have a significant amount of pain after tonsillectomy, with pain resolving 5-12 days after surgery. Older children and adults seem to have more discomfort. Most patients can go home the day of surgery.

  • Ear pain: Many children will complain of ear aches after tonsillectomy. This is caused by pain coming from throat and not the ears. Give pain medications and encourage liquid intake.


  • Fever: Many patients have a low-grade fever after tonsillectomy - up to 101.5 degrees (380 C.). Give Tylenol and plenty of fluids. Higher prolonged fever should be reported to your surgeon.


  • Bad looking (and bad smelling) throat: Most tonsillar areas (after surgery) are covered with a white exudate - sometimes with bad breath - for up to 12 days. There be some redness and swelling as well. The uvula (the thing hanging down in the middle) is occasionally swollen.



When should we call the doctor?

  • Bleeding: Significant bleeding is rare. More than two tablespoons of fresh blood should be reported. If bleeding persists, ice water mouth washes may help. For severe bleeding, go to the nearest emergency room.


  • Dehydration: If there has been little or no liquids taken for 24 hours, notify your surgeon. Signs of dehydration include lethargy, and reduced or very concentrated urine output.


  • High Fever: Temperatures greater than 1020, or when accompanied by cough or difficulty breathing, should be reported





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