What are tonsils?
Tonsils are lumps of lymphoid tissue in the back of the throat. Lymphoid tissue traps germs and produce antibodies to fight infections.
Does our body need them?
No. The body can fight infection without tonsils. That certainly does not mean they should be removed unnecessarily.
Why remove them?
To stop the frequent infections (tonsillitis) that can cause various problems. Some children have huge tonsils that obstruct their breathing at night. Severe episodes of tonsillitis can cause an abscess in the throat. This is pus behind the tonsils and needs immediate admission to hospital for treatment. There are other reasons that sometimes necessitate the removal of tonsils. A doctor will explain to you why you need to have an operation.
How is the surgery performed?
You come to the hospital at the time determined for admission as an inpatient. The surgery is done under general anesthesia. We use special tools to keep your mouth open and remove the tonsils through your mouth, it takes about 30 minutes. You wake up in the recovery room adjacent to the operating theatre.
How long will I be in hospital?
You will go home the same day or the next if you can eat and drink and feel well enough.
Can there be problems?
Tonsillectomy surgery is very safe. However, every operation has a small risk. The most common problem is bleeding. It happens in about one in a hundred cases and is usually treated in the office. Very rarely you may need to go back for surgery. Also during surgery there is very slight chance of getting injured a tooth. Sometimes children’s voices change a little for a short time.
SURGERY PREPARATION
For children: Talk to your child about the surgery in words he/she will understand. Τell them a story such as Good-bye Tonsils! .
For adult patients: Make plans to take 1 ½ to 2 full weeks off from school or work. You may feel like going back sooner than that, but just plan for the worst case scenario.
Note: Don’t take ibuprofen or aspirin for 2 weeks before and 2 weeks after the day of surgery. Ibuprofen increases the risk of bleeding during and after surgery.
THE SURGERY
A tonsillectomy and adenoidectomy are often done at the same time and are commonly referred to as “T&A”. T&A is an outpatient surgical procedure that takes between 30 to 45 minutes and is performed under general anesthesia . A metal retractor called mouth gag is used to hold the mouth open to perform the procedure. The tonsils are grasped and removed from the surrounding muscle and tissue by using a coblation radiofrequensy or cold instruments . After the tonsils and/or adenoids have been removed, any bleeding is controlled .The anesthesiologist will wake you up and transfer you to recovery. The recovery nurses and anesthesiologist will monitor you until you’re ready to go to your room. Normally, young patients will remain at the hospital for about 10 to 12 hours after surgery for observation.
For the adenoids, the soft palate is retracted and a mirror or camera is used to look into the back of the nose where the adenoids are located. The adenoids are remove with cold instruments or shaver. Adenoidectomy recovery is 2 -3 days.
Follow-up:
I will see you 6-7 days after surgery.
RECOVERY FROM A T&A:
Recovery time: most children require 10 – 15 days to recover some may recover more quickly; others can take up to 3 weeks for a full recovery . Let them go back to school after 15 days. Also no travel within 14 days of surgery.
Drinking/Eating: You/your child MUST drink plenty of fluids- this is the most important thing you can do for you/your child’s recovery!! Some don’t like to drink milk products because it does increase the thickness of your mucus- but I’m not going to argue with you if you want a glass of milk with every meal. For kids, try juice, soft drinks (non-caffeinated), popsicles and Jell-O for the first couple of meals- if they’re eating this well and want something more substantial, go for it! Also try pudding, yogurt, ice-cream, mac & cheese, and luke warm soup.
Try to avoid high acid content food (citrus) and spicy food. The sooner you/your child eats and chews, the quicker the recovery.
Fever: A low-grade fever is common for several days after surgery. Fever is often related to dehydration – so drink more fluids if fever is present. Contact me if the fever is greater than 38,5°C
Activity: Activity may be increased slowly, with a return to school after normal eating and drinking resumes, pain medication ceases, and your child sleeps through the night. Travel away from home is not recommended for two weeks following surgery.
Breathing: You may notice your child still snores or mouth breathes after surgery. The snoring should subside around 5-7 days after surgery.
Scabs: Scabs will form where the tonsils and adenoids were removed. These scabs are thick, white, and cause bad breath for 10-14 days after surgery. This is not an infection!
Bleeding: With the exception of small specks of blood from the nose or in the saliva, bright red blood should NEVER be seen. If such bleeding occurs, contact me immediately or take your child to the emergency room. The most common time to bleed is 10 – 14 days post-op.
Pain: Nearly all children undergoing a tonsillectomy/adenoidectomy will have mild to severe pain in the throat after surgery. Some may complain of an earache (this is “referred” pain from the throat that is felt in the ears) and a few may have complaints of pain in the jaw or neck. The pain is usually worst on post-op day 5, so beware!
Medications after surgery: For children, I will prescribe pain medication such as Paracetamol . For adults, I usually give Paracetomol with codeine. Take your pain medicine/give pain medicine to your child on a scheduled (every 4 or 6 hour) basis for the first 6-7 days. Stay ahead of the pain, don’t wait until there’s pain to take the medicine; you’ll be miserable and may get dehydrated. Antibiotics are given to help with the bad breath. Steroids may be given to help with the swelling and/or pain.
When to Call the Doctor