Tonsils and
Adnoids
What are the
tonsils and adenoids?
Enlarged
or chronically infected tonsils and
adenoids are one of the most common
problems that we see. The tonsil is
lymphatic tissue located on each
side of the throat. It is nestled
between folds of muscles in the
throat.
The
adenoids are lymphatic tissues that
are located behind the nose where
the nose and throat come together.
These tissues normally help to
fight infections that enter the body
through the nose and mouth.
When these
tissues are infected, they become
swollen, red, covered in pus and
painful. Usually antibiotics are
effective in curing acute infections
of the tonsils and adenoids. As the
infection resolves, the swelling,
redness, etc. in these tissues will
go away. However, in some children
and adults, these tissues become
chronically enlarged or infected,
and antibiotics do not help the
swelling to resolve.
Patients
with chronically enlarged tonsils
and adenoids can have symptoms of
snoring, difficulty swallowing,
painful swallowing, bad breath, ear
infections, or chronic nasal
drainage. Some children can have so
much obstruction of the nasal
passage that they breathe through
the mouth only. Enlargement of the
tonsils and adenoids, by virtue of
blocking the upper airway, can make
the voice sound muffled or give the
impression that one "always has a
cold."
Tonsillectomy
and Adenoidectomy
In patients
with chronically infected tonsils or
adenoids, surgery can be performed
to remove these infected and
overgrown tissues and relieve the
symptoms of airway obstruction.
These procedures are performed under
general anesthesia. The tonsils and
adenoids are removed through the
mouth. The procedure takes less
than one hour. After the surgery is
completed, patients will be observed
for several hours. If the patient
meets certain criteria and has no
problems that would require
additional observation or in-patient
treatment, then he or she can be
sent home.
Medications
Most
patients are given pain medication
and/or antibiotics. Take the
antibiotics until they are
finished. Use the pain medication
as prescribed. Avoid driving if you
are taking narcotic pain medication.
Diet
Immediately
after surgery, the patient should
begin to swallow clear liquids. It
is very important that one drinks
plenty of liquids following this
surgery to avoid dehydration. Fruit
juices like grape and apple are
better tolerated than those which
are more acidic like orange juice
and lemonade. Usually the diet can
be expanded to soft foods over the
next few days after surgery. Ice
cream, Jell-O, pudding, yogurt are
usually well tolerated. Hard
foods, like chips or popcorn, should
be avoided for one week after
surgery. Hot foods, like coffee,
should be avoided since they might
promote bleeding.
Activity level
Patients
should avoid strenuous activity for
at least one week following surgery.
Children who have had adenoidectomy
alone can usually go to school or
daycare the day after surgery.
School-age children should stay out
of school for one week after surgery
following tonsillectomy.
Adults
should stay home from work for one
week, especially if they are taking
narcotic pain medications.
Occasionally, adults require a
longer period of recovery. Please
discuss this with your physician.
Problems after
surgery
Problems or
complications can occur after any
surgical procedure. Your physician
will discuss some of these
complications prior to your
surgery. If you develop any of
these problems, please contact your
physician.
-
Bleeding after tonsillectomy
and/or adenoidectomy can occur
in 1-2% of patients. Bleeding
can occur up to 7-10 days after
surgery. Oftentimes, drinking
plenty of liquids after surgery
can help to prevent bleeding
from occurring. This bleeding
can be a serious problem
depending on the amount of blood
loss and the size of the
patient. You should call your
physician, (713)795-0111, if
any bleeding develops after
surgery. If for any reason you
cannot contact your physician,
then please go to the nearest
emergency room for evaluation
and treatment.
-
Ear
pain can occur in up to 20% of
patients after tonsillectomy.
This ear pain is usually caused
by irritation of sensory nerves
in the area of the tonsil that
also give sensation to the ear.
As the tonsillectomy site heals,
the ear pain will go away.
-
Fever
is not uncommon for the first
day or so after tonsillectomy.
Usually the temperature will not
exceed 101oF.
Frequently, the pain medication
will contain acetaminophen, and
this will help the fever to go
down. Be careful not to give
acetaminophen in addition to the
pain medication unless under the
direct order of your doctor.
Over dosage of acetaminophen can
lead to liver damage. If fever
persists past the second day
after surgery or exceeds 101oF,
please call your doctor.
-
Swallowing problems are not
uncommon after surgery. This is
understandable since patients
have pain in their throat, and
this pain is worsened by
swallowing. Usually taking the
prescribed pain medication will
relieve this pain and allow for
easier swallowing. Parents
should give their children pain
medication and wait for 30
minutes or so before encouraging
their children to drink. Some
swallowing problems are probably
related to tightness or spasm in
the throat muscles. Some
patients find that chewing gum
helps to diminish this spasm.
-
Voice
change can occur after
tonsillectomy and
adenoidectomy. Usually the
voice will sound clearer after
surgery than it did prior to
surgery. Rarely, patients try
to avoid moving the soft palate
after surgery to minimize their
pain; and this will produce a
voice that sounds like it is
coming from the nose instead of
through the mouth. This voice
change will resolve as the
throat pain resolves.
Follow-up
visit
Please
contact our office to schedule a
follow-up visit two weeks after your
surgery. If you have one of the
problems listed above, please call
our office, (713) 795-0111, to
schedule an earlier appointment.
