Tonsillectomy and Adenoidectomy

The tonsils are located on each side of the back wall of the throat, just above and behind the tongue. The adenoids are found above and behind the roof of the mouth – where the nose and mouth join. These tissues help defend the body against infection. When they are overcome by chronic infections, or when their enlargement blocks breathing, the tonsils and/or adenoids may need to be removed. The operation takes about 30 minutes.

What to Expect After Surgery

You or your child may lack energy for several days. Constipation may also occur. This is due to less food and fluids taken and/or the use of narcotic pain medications.

Bleeding

The risk of bleeding is about 3% and can occur for up to 10 days after surgery. No new bleeding (bright red blood) is expected from the nose or mouth. If fresh bleeding occurs proceed to the closest emergency room for examination. For older children and adults, first try to gargle with cold water several times. This will help to constrict the bleeding vessel.

If the adenoids were removed, do not allow your child to blow his or her nose for 3 days. This may cause bleeding. It is safe to sniff gently as needed.

Diet

We suggest you drink cold liquids every waking hour for the first 24 hours. Good choices include cold water, fruit juice, Jell-O, popsicles, slush, Gatorade, and Pedialyte. You may advance the diet to soft, then solid foods at any time after surgery. If you/your child are/is nauseated and vomits, withhold food or drink for 30 minutes. Then start with clear liquids, progressing to solid foods once clear liquids are tolerated without vomiting

Temperature

A slight fever is normal for 24-48 hours after surgery. Drinking plenty of fluids will help keep the fever down. If the fever rises above 101.5ºF, please contact your doctor.

Pain

Throat pain can be severe after a tonsillectomy. You may also experience some ear pain. The nerve that goes to the tonsils also goes to the ears causing pain to be felt in the ear. After the operation, give the prescribed pain medication as directed. Do NOT use aspirin, medication containing aspirin (i.e. Excedrin) as it will increase the chance of bleeding. Ten days after surgery, ibuprofen may be used as needed for adults. Over the counter acetaminophen (Tylenol) can be used at any time. Additional medications will be prescribed to help control throat discomfort.

Other ways to decrease throat pain are:

  1. Drinking cold liquids. They moisten the throat and reduce the swelling
  2. Cool compresses and ice collars on the neck
  3. Ice chips or chewing gum (only for children 6 and over) will also moisten the throat

Bad Breath

Bad breath is common after a tonsillectomy or adenoidectomy. It is caused by the white-yellowish membrane that forms in the throat where the surgery took place. Bad breath may be improved by gargling with a mild salt-water solution. This is made by adding 1/2 teaspoon of table salt to 8-ounces (1 cup) of tepid tap water.

Nausea & Vomiting

Odansetron (Zofran), promethazine (Phenergan), prochlor- perazine (Compazine), or pills or suppositories may be used to control nausea and vomiting. The dose may be repeated once after 6 hours. If vomiting continues after the second dose, call your doctor or the local hospital emergency room.

Activity

For the first 10 days, you/your child may resume “light duty” activity – avoid heavy lifting or straining (excessive play or exertion). Your/your child may experience alternating “good” and “bad” days for 2 weeks after surgery – recovery can be irregular. It is a good idea to keep yourself/your child away from crowds and ill people for 7 days, since the throat is susceptible to infections during this period. Restrict travel to within 30 minutes of a medical center or E.R. for 2 weeks following surgery. Do not drive while taking narcotics (i.e. Lortab or Percocet). Finally, always follow your doctor’s orders if they differ from these instructions.

For More Information Visit

American Academy of Otolaryngology
WebMD