Patient Information for Tonsillectomy and/or Adenoidectomy Surgery

NO ASPRIN, NAPROSYN OR IBUPROFEN 2 WEEKS PRIOR TO SURGERY. TYLENOL ONLY.”

 

The information contained here is provided to you to explain what tonsillectomy and/or adenoidectomy surgery involves, the indications for the surgery, and the possible complications related to the surgery. The adenoid tissue and tonsil tissue are tissues in the back of the nose and throat which are very similar to the glands in the neck which might help produce some of the white blood cells and antibodies which fight infection in your body. The tonsils and adenoids are only a part of an entire ring of such tissue which encircles the back of the nose and upper throat. Since the nose and throat are major points of entry for germs, these tissues function to help ward off infection. However, at times, these tissues, particularly the tonsils and adenoids, become infected themselves, or become so enlarged as to produce obstruction to the air and food passages.

 

If an individual has more than four (4) episodes of acute tonsillitis in the course of a year, or if the tonsils are so large as to obstruct the air and food passages, then the individual may be considered a candidate for tonsillectomy. Removing the tonsils will not necessarily stop all sore throats, because many sore throats do not involve the tonsils at all. In addition, the enlargement of the adenoid tissue may be such that it obstructs the eustachian tubes which are responsible for draining the ears. If this occurs, the individual may develop middle-ear fluid or recurring infections. Adenoidectomy may be recommended when children have recurring ear infections or persistent fluid behind the eardrum. If the adenoid tissue is blocking the nasal passages in such as a way that the individual cannot breathe through his/her nose, or may be having problems with development of normal tooth position, then adenoidectomy may be considered.

 

At times, tonsillectomy and adenoidectomy are done as a combined procedure. These procedures are generally done in the operating room at a hospital or outpatient surgery center and may involve admitting the patient overnight to a hospital after the surgery is performed. Preliminary laboratory are done to be sure that the individual has a normal blood count and blood-clotting ability, at the discretion of the physician. Tonsillectomy and adenoidectomy must be considered major surgery, though the procedures are generally relatively short. Children are always operated under general anesthesia, though adults are occasionally done under local anesthesia. The operative procedure usually require 20 to 30 minutes of operating time, but the patient will usually be in the operating room for 45 minutes to an hour, including the time required to anesthetize the patient and to awaken the patient after the procedure.

Early Concerns

"MY THROAT HURTS"... You should expect to have a sore throat anywhere from a few days to about two weeks. Usually children get over it more quickly but do not be alarmed if your child requires the full two weeks to recuperate. If you look at the back of your throat it might be covered with a white or yellowish coating. This is normal and will clear up in about two weeks. Keep your throat wet by drinking small amounts of liquids frequently. Try a vaporizer in the room to humidify the air. Do not smoke for 10 days following surgery.

 

"WHAT IF I BLEED?"... Although uncommon, you might spit out a little blood at times. You could try to gargle with cold water or a mixture of half peroxide half water. If you experience bleeding that will not stop after 15 minutes or is extremely heavy bleeding you will need to go to the Emergency Room.

 

"I HAVE A TEMPERATURE"... The main reason for a temperature is failure to consume enough fluids, inactivity and failure to clear secretions from the lungs. Please get up to move about house to help prevent the latter problem. You should be able to control an oral temperature of 103 degrees if you do the following:

 

INCREASE YOUR FLUID INTAKE: You are not drinking enough if you are not urinating at least 2-3 times a day.

GIVE MEDICINE: To lower fever give Tylenol or any equivalent that DOES NOT CONTAIN Ibuprofen, Naprosyn or Aspirin.

TRY A SPONGE BATH: Get in a tub of LUKEWARM water (an inch or two of water for children). Dip a washcloth in the water, wipe it over the body and then let the water evaporate. If you have an oral temperature of 103 degrees or greater that does not respond to the above recommendations then call your doctor.

 

"MY EARS HURT"... You will probably have pain in your ears. This does not mean you have an ear infection. It is the pain from the throat that causes the ear to hurt since the throat and the ear share a common nerve. Usually the earache will get better as the sore throat goes away.

 

"MY NECK HURTS"... If the adenoids were removed you may experience a stiff and painful neck that may persist for up to 2 weeks.

 

"IT HURTS TO DRINK"... You must consume enough fluids to avoid dehydration. You are not drinking enough if you are not urinating at least 2-3 times a day. You can have water, juice, Jell-O, broth, popsicles or crushed ice.

 

"WHAT CAN I EAT?"... Most foods can be eaten if chewed well. Cold foods such as jello or popsicles usually make your throat feel better.

 

"WHAT YOU SHOULDN'T EAT"... Avoid foods that scratch the throat (such as potato chips or pretzels) foods that irritate the throat (such as orange juice or hot, spicy foods) or foods that thicken the saliva (if it's enough that it bothers you).

 

"I HAVE BAD BREATH"... Bad breath is common and should disappear in about two weeks. You can try rinsing the mouth with a saltwater solution 1 tsp. salt to 1 quart warm tap water 3 to 4 times a day. Avoid mouthwashes with alcohol. Be careful when brushing your teeth.

 

"CAN I BLOW MY NOSE?"... Expect some nasal discharge. Do not blow your nose forcefully, for 2 weeks following removal of adenoids.

Activity

Children may go back to school whenever they feel well enough. This may be 4-5 days or they may require the full two weeks to recuperate. Children should avoid strenuous activity (such as GYM class) for the full two weeks. Adults usually take longer to recover. They can go back to work whenever they feel well enough, but should avoid straining, bending and heavy lifting for the full two weeks.

Medicine

1. You can take Tylenol or equivalent but you MUST NOT take medicine that contain Aspirin, Naprosyn or Ibuprofen for at least 10 days following surgery since they can promote bleeding.

 

2. Use all medicines as prescribed by the physician.

 

3. Legal decisions and risky activity (such as driving) should not be done while you are using strong pain medication. RETURN VISIT: Finally, please follow any specific instructions given to you and keep your follow-up appointment as arranged. You will be given an appointment card when discharged from the facility.