Tonsillectomy 

 

TONSILLECTOMY is a common procedure, performed on both children and adults.

 

Mr Russell will have discussed the reasons for the operation. Most people are recommended for this surgery because of recurrent tonsillitis or airway obstruction. There are other possible indications for this operation - including quinsy, snoring, chronic sore throats and ear infections.

 

Admission will be on the day of surgery. Once in hospital, routine admission procedures will take place, involving interviews with nursing staff. This will provide the information necessary for your comfort and medical care.

 

The anaesthetist will visit to explain the form of anaesthetic to be used.

 

A nurse will accompany you (and, if you are a child, also your parent) to the operating theatre, where you will meet one of the operating room nurses, and the anaesthetist. The anaesthetist will then commence the anaesthetic using the method that was explained previously.

 

 

THE OPERATION

 

The tonsils are positioned at the back of the throat, one on each side. Removal of the tonsils involves separating them from the underlying muscle either using diathermy, or the latest technique, Coblation.

 

The adenoids lie as a cushion at the back of the nose. They are removed (often at the same operation) through the mouth from behind the palate.

 

 

AFTER THE OPERATION

 

PAINKILLERS will be given during the surgery, but the sore throat will still be the first thing noticed. It is quite normal to have pain in the throat. The operative site will be a raw surface that will take up to TWO WEEKS to heal.

 

EATING AND DRINKING is recommended as soon as possible after the operation. It is VERY IMPORTANT to drink frequently and eat small amounts regularly as this will reduce the amount of discomfort experienced and will also speed the recovery. Chewing gum may be recommended between meals and  can be helpful for referred ear pain.

 

PAINKILLERS will be given in the ward regularly, usually orally. These should be continued at home regularly as eating will be made much easier.

 

Most people are able to go home on the day of the surgery, after several hours of observation in the ward. The day following the operation, the discomfort may be a LITTLE WORSE. This is quite common. It is very important to continue to eat and drink regularly once leaving hospital.

 

You will be provided with medication on discharge and instructed about doses and frequency. Expect that there will still be a sore throat despite the medication, but this will progressively improve. If more analgesia is required, please contact Mr Russell.

 

 

COMPLICATIONS

 

Surgery will have been advised because of the effect illness may have on your health.

As with all operations, there are potential problems that may arise.

 

Bleeding

Bleeding from the operative site is the most concerning complication of this procedure.

The raw tonsil bed surface may ooze a little in the first 3-4 hours. Rarely more severe bleeding may occur, requiring control by a second operation.

If there is any bleeding at home, suck ice, sit upright in a cool place and ring Mr Russell if it does not stop within 10 minutes. If bleeding is severe call Mr Russell as soon as possible and if concerned attend University Hospital, Geelong Emergency Department.

 

Pain

PAIN IS NORMAL after this surgery. It should be like a severe throat infection. The discomfort may increase in the first week, peaking between day 4-6. Sometimes the pain shoots into the ear. You will be prescribed medication by Mr Russell. Please  ensure you understand how to take the medication before you leave hospital. If simple pain killers are not helping, the rooms or Mr Russell should be called. Local anaesthetic lozenges or 'Difflam' can be often helpful. Chewing gum can help with ear pain.

 

Dental Injury

During the operation, there is a slight risk to the teeth from the mouth gag used. It is important to tell Mr Russell or the anaesthetist prior to the operation, if there are any loose or chipped teeth.

 

Anaesthetic

A recent cold or chest infection may lead to problems  with the anaesthetic.

Please alert Mr Russell or medical staff if  you have an allergy to medications or a family history of anaesthetic reactions.

It is important to answer any questions asked by medical staff accurately as this may prevent serious complications.

 

Jaw problems

It is not uncommon to experience discomfort in the jaw for a time after the operation. This will settle quickly over the first couple of weeks.

 

 

COMMONLY ASKED QUESTIONS

 

Do I really need this operation?

There are generally alternative treatments for all illnesses, however if surgery is suggested, it will be because other methods have not been, or would not be effective. If your decision is being reconsidered, please discuss this with Mr Russell.

 

What will I be able to eat?

After this operation, it is important to return to a normal diet as soon as possible. It is obviously easier to eat soft and  food that is not too hot, but food must be eaten that requires chewing, for example, toast, sandwiches, etc. Chewing gum may aid the recovery.

 

 

When will I be able to return to school / work?

Return to strenuous exercise,school or  work is NOT recommended for at least one week. The energy will be lacking and there is a risk of bleeding from the raw surface before it heals. In the second week, there should be a slow build up towards normal activity.

 

If I am having my tonsils/adenoids removed, why do I have them in the first place?

The tonsils and adenoids are a source of blood cells that help fight infection. Their major role occurred in the first months of life, when they acted as a filtering system, allowing a baby to adapt to life in the outside world. After about six months, babies will have developed immunity, and the tonsils/adenoids loose their primary role.

 

 

I have heard that tonsils/adenoids may grow back. Why does this happen?

Tonsils or adenoids may regrow from tissue remaining in the throat. This is, however, rarely the case. Reformed tonsils may become infected again and regrown adenoids may block the nose. These circumstances would be managed on an individual basis.

 

 

DISCHARGE INSTRUCTIONS

 

It will take you approximately TWO WEEKS to fully recover from this operation. To assist the recovery, please follow these instructions.

 

1. Eating and drinking is vital to your recovery. Small  frequent meals and  drinks are to be encouraged at first, increasing to normal diet as soon as possible. It is important to eat solid food to keep the throat muscles moving, and the throat clean.

 

2. The pain will be worse on wakening in the morning, and at the start of every meal. The pain may seem to be coming from the ears. The analgesia ( pain relief medication) should be taken as  advised during the stay in hospital or by Mr Russell. Meal time can be made more comfortable by taking your pain relief  one hour before your  meal where possible.  Chewing gum can help with ear pain. Do not wait until the pain arrives. Regular  doses of analgesia will help you if required.

Please call rooms if you require advice or another script.

 

3. Prepare to stay off school/work for one week up  to two weeks. Generally children are well enough to return after the week, activities can be limited in the second week.

 

4. Keep away from irritants i.e. smoke, dusts, pollen, aerosol sprays and extremes of temperature.

 

5. Avoid people with infections.

 

6. Do not drink alcohol, it could cause bleeding.

 

It may be felt that your progress is not steady, some days are better than others. This is quite normal. If concerned, please contact the rooms.