Tonsillectomy and Adenoidectomy
A tonsillectomy is a surgery to remove the tonsils. The tonsils are two pads of tissue located on both sides of the back of the throat. Often, an adenoidectomy (excision of the adenoid glands) is done at the same time. The tonsils and adenoids help protect our bodies against infections. Tonsils and adenoids are often removed when they become enlarged and cause breathing obstruction and/or recurrent throat infections.
It is typically an outpatient surgical procedure lasting between 30 and 45 minutes and performed under general anesthesia. Your child will remain in the recovery room after surgery until they are awake and can breathe easily, cough, and swallow. Most children remain in the hospital for about 4 hours after surgery. An overnight stay may be required if there are complications or if your child has a history of another medical problem that would deem an overnight hospitalization necessary.
Risks for any anesthesia are: reactions to medicines and breathing problems.
Risks for any surgery are: bleeding and infection.
Before the Procedure
- Nothing to eat or drink after midnight the evening before the procedure. Small children may need to avoid food and drink for a shorter time. Please be sure to ask. You may not be able to undergo the surgery if you do not follow these instructions.
- Ask your doctor what medications you should take on the day of surgery. The day of surgery, you may take the medicine(s) you are supposed to take with a sip of water.
- A week before the surgery, please avoid aspirin, aspirin-containing products, ibuprofen (Advil, Motrin, Aleve) or Vitamin E. Please notify our office if you are on any medications that affect bleeding, such as coumadin or warfarin. Please call our office if you have any concerns about any medications. (585-342-2080)
- Please call our office if your child gets a fever, cold, or rash prior to the procedure. Surgery may need to be postponed.
After the Procedure
Your child will go home on the same day as surgery. Complete recovery takes about 1 to 2 weeks. Some may recover more quickly.
Diet: Fluids are more important than solids. The goal is to avoid dehydration. Begin with clear liquids and advance to a soft diet as tolerated. Fluids may be given in almost any form, such as: water, juice, popsicles, jell-o, gatorade, soup, kool-aid, soda pop. Citrus juices, pineapple and tomato juice, may sting due to the acid. Milk products may thicken phlegm, but can be followed by water if desired by the patient. Examples of soft foods: mashed potatoes, pudding, yogurt, ice cream, applesauce, oatmeal, Cream of Wheat, soups. Avoid hard foods and foods with sharp edges.
Some patients experience nausea and vomiting after the surgery caused by the anesthesia. This usually occurs within the first 24 hours and resolves on its own. Nausea thereafter is likely due to taking narcotic medications on an empty stomach.
Contact our office if there are signs of dehydration. (Urination less than 2-3 times a day or crying without tears.)
Activity: No strenuous activity or play for 2 weeks. Avoid bending, lifting or straining. Activity may be increased slowly as tolerated.
Medication/Pain: Pain in the throat may last for 7 to 14 days. You will be given a prescription for pain medication for the first few days. Use as directed. It is common to develop an earache, which is usually referred from the throat. You may find an ice pack or warm compress to be soothing. Your discomfort may seem worse 4-5 days after surgery. This is a normal part of the healing process and will improve within a few days.
Bleeding: A scab will form where the tonsils and/or adenoids were removed. The site should look like white patches. They are not a sign of infection, but they may cause bad breath. It is common for bleeding to occur and it is usually not serious. Remain calm. The patient should lay quietly on his stomach with his face turned to one side for roughly ten minutes. If the bleeding does not stop contact our office. If it does stop, the patient should remain relatively quiet for about 24 hours and refrain from eating solid foods.
Fever: Slight elevations of temperature (99°-100° F) during the first few days are common due to the anesthesia. Fluid intake should be encouraged. Please contact our office for a temperature above 101°F.
Infection: A small percentage of patients develop infections. Watch for signs of fever, cough, nasal drainage, and increased discomfort.
Nightmares: Children may experience nightmares following surgery. They are best handled by parental reassurance.
Follow-up Visit: You will have a follow-up appointment scheduled for two weeks after surgery. Our office will notify you of your appointment time and date.
Please call our office at 585-342-2080 for any of the following:
- Persistent bleeding
- Inability to eat or drink
- Fever above 101°F
- Nausea and/or vomiting
- Pain not relieved by prescribed medications and instructions above.
- Please do not hesitate to call our office with any other questions or concerns.