Tonsillectomy and Adenoidectomy Post Operative Instructions

Tonsillectomy and Adenoidectomy Procedure

The tonsils are two pads of tissue located on either side of the back of the throat which can become enlarged in response to recurring infections or strep throat. A tonsillectomy is recommended when infections become frequent enough that it interferes with a patient’s general health (such as airway obstruction as well as hearing). Enlargement of the tonsils can also lead to enlarged adenoid glands, which commonly results in an adenoidectomy. The adenoids are similar to tonsils, but are located in the back of the nose. If enlarged they can compress the Eustachian tube causing fluid in the middle ear and frequent ear infections.

Effects of Anesthesia

You or your child received general anesthesia for this procedure and may feel somewhat dizzy and/or sleepy after the surgery. Anesthetic agents can remain in one’s body for up to 24 hours. It is important to rest for the remainder of the day and for your child to be under adult supervision. Your child should not ride his/her bike or perform such activities that require coordination.

Postoperative Care

Pain Management

Patients tend to experience a fair amount of pain post surgery. An earache is a common complaint among patients following tonsillectomy. The same nerve that travels to the throat is connected to the ear, so stimulation of this nerve can feel like an earache. Expect some discomfort while eating, drinking and sleeping. This discomfort can fluctuate from mild to severe for up to 14 days.

Medicate as prescribed for pain. DO NOT take Aspirin, Aspergum, Advil or Ibuprofen.

Things you can do to relieve the pain:

• Ice the neck
• Chew gum
• Have a humidifier in the room
• Gargle with cold water

Eating/Drinking

Expect some discomfort when swallowing food. Many children are uninterested in eating for up to a week. Hydration is extremely important! Encourage: juice (except for drinks that are high in citrus like lemon, lime, and grapefruit). Encourage: jello and popsicles or ice chips. These not only help in hydration but sooth the throat. Avoid: milk products such as pudding, yogurt, and ice cream for the first 24 hours. Also stay away from sports drinks like Gatorade, which dry the throat up. Pedialyte is okay. Stay away from foods like chips and crackers which can scratch the back of the throat until you see your doctor for the follow up appointment.

Signs of Dehydration

• Dark urine
• Urinating less than two to three times a day
• Crying without tears
• Lethargy
• Dry skin
• Temp greater than 101

Breathing

Snoring and mouth breathing are normal after surgery because of swelling. Normal breathing should resume 10-14 days after surgery. It is normal to have liquid go up the back of your nose after an adenoidectomy surgery. This may occur for a few days following the surgery.

Activity

Light activity for up to 10 days. Generally, children may return to school when they are eating and drinking normally, off of all pain medications and sleeping through the night. This is 7-10 days on average and can be less or more depending on the conditions. However keep in mind that even though the patient may be feeling fine, they are at risk for bleeding up to 14 days after surgery. No diving into pools until after your follow up check with your doctor.

Bleeding

If there is excessive bleeding (more than a little spit up) from the mouth or nose consult your doctor immediately. If it isn’t office hours go straight to the Emergency Department. This could be a result of the scabs falling off too early and needs immediate attention. *Note: It is not unusual to vomit up old blood and gastric secretions after surgery (once or twice) but if it persists consult the doctor. You may also notice large white patches in the back of your child's throat after surgery, for up to about two weeks, this is completely normal.

Notify your doctor if the following occurs:

• You are unable to swallow fluids
• You notice bleeding in the back of your throat and/or are spitting up blood
• You have a fever greater than 101 degrees
• You have severe pain that is not relieved by your pain medicine

Contact the Otolaryngology Department at 617-630-1699 with any questions.