Tonsillectomy

Physical exam of the tonsils, throat, and neck, at minimumBlood testPossibly a urine testReview of medications; some may need to be stopped or adjusted for the procedure In the days leading up to your procedure: Do not take aspirin, aspirin-containing medications, or other nonsteroidal anti-inflammatory medications (NSAIDs).The night before, eat a light meal and do not eat or drink anything after midnight, including mouthwash, toothpaste, lozenges, chewing gum, and water. During ProcedureAnesthesia, and possibly sedationBreathing tubeRetractor that holds your mouth openDepressor that holds your tongue down AnesthesiaGeneral anesthesia is most common, but tonsillectomy can be performed with sedation and local anesthesia. Description of the Procedure One at a time, the surgeon will grasp each tonsil with tonsil forceps and cut it away from surrounding tissues. The tonsil is then removed with a snare or a tonsil guillotine clamp. Electrocauterization (scarring with an electrical current) or clamps and ties are used to stop bleeding from the blood vessels at the site where the tonsils were removed. Radiofrequency ablation can be used to reduce the volume and size of the tonsils.

After Procedure The site where the tonsils were removed should heal within 7 to 10 days. Postoperative symptoms include, but are not limited to: Swallowing problemsThroat painEar painVomitingFeverBleeding from the site where the tonsils were removed How Long Will It Take?The procedure typically takes 20 to 60 minutes. Will It Hurt?Anesthesia prevents pain during the procedure, but pain after the procedure is common. Your doctor may prescribe pain medication or recommend over-the-counter pain drugs for you. Possible ComplicationsExcessive bleeding from the site where the tonsils were removedAdverse reaction to the anesthesia Vomiting and dehydration Average Hospital StayAn otherwise healthy person can usually have this procedure done on an outpatient basis. Some patients may need to stay in the hospital for up to two days. Postoperative CareDrink plenty of fluids (avoid acidic drinks)Take acetaminophen (Tylenol) or other pain medication prescribed by your physician to relieve painApply ice to relieve painTake antibiotics, if they are prescribed, to treat or prevent infectionAvoid talking, coughing, and singing for one weekAvoid swallowing hard items such as crackers and hard cookies, as they may injure the back of the throatAvoid vigorous exercise for 12 to 14 daysAvoid spicy, acidic, and hard-to-digest foodsEat soft foods such as gelatin and pudding for 3 to 4 days after surgery, and gradually return to a normal dietBathe or shower as usual OutcomeOutcomes vary depending on the reason for the tonsillectomy. They include:

Fewer throat infectionsImproved breathing and swallowing Call Your Doctor If Any of the Following OccursSigns of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the site where the tonsils were removedSevere or worsening painNew, unexplained symptoms RESOURCES: American Academy of OtolaryngologyHead and Neck Surgeryhttp://www.entnet.org Kids Healthhttp://www.kidshealth.org/parent/medical/ears/tonsil.html CANADIAN RESOURCES: BC Healthguidewww.bchealthguide.org/kbase/topic/major/ut1026/cause Canadian Family Physicianwww.cfp.ca References: Alexander's Care of the Patient During Surgery . 11th ed. Mosby; 1999. American Academy of OtolaryngologyHead and Neck Surgery website. Available at: http://www.entnet.org . Last reviewed November 2007 by Elie Rebeiz, MD, FACSPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.