Adenoidectomy (Tonsillectomy)

1 What is an Adenoidectomy (Tonsillectomy)?

Tonsillectomy and adenoidectomy are surgical procedures performed to remove the tonsils and adenoids.

The tonsils and adenoids are masses of immune cells commonly found in lymph glands (lymphoid tissue) located in the mouth and behind the nasal passages, respectively.

When the tonsils are infected or enlarged, they may cause a chronic or a recurrent sore throat, bad breath, dental malocclusion, abscess, upper airway obstruction causing difficulty with swallowing, snoring, or sleep apnea. Infected adenoids may become enlarged, obstruct breathing, cause ear infections or other problems.

In most situations, the surgery is performed as an outpatient at either a hospital or a surgery center. The patient should not take aspirin, or any product containing aspirin, within 10 days of the date of the surgery and non-steroidal anti-inflammatory medications (such as ibuprofen, Advil, and others) within 7 days of the date of surgery.

The patient must not eat or drink anything 6 hours prior to the time of surgery. This includes even water, candy, or chewing gum. Anything in the stomach increases the chances of an anesthetic complication.

If the patient is ill or has a fever the day before surgery, or patient wakes up sick the day of surgery, call the surgeon's office. The doctor will decide if it is safe to proceed with surgery.

Usually, in the pre-operative holding room, a nurse will start an intravenous infusion line (IV) and the patient may be given a medication to help them relax. In the operating room, the anesthesiologist will usually use a mixture of gas and an intravenous medication for the general anesthetic.

During the procedure, the doctor will remove the tonsils and/or adenoids through the mouth. There will be no external incisions. The base of the tonsils and/or adenoids will be burned (cauterized) with an electrical cauterizing unit. The whole procedure usually takes less than 60 minutes.

The patient should arrange for someone to take them to the surgical facility, back home, and to spend the first night after surgery with the patient.

After surgery, the patient will be taken to the recovery room where a nurse will monitor them. The patient will be able to go home the same day as the surgery once they have fully recovered from the anesthetic, after several hours.

Also, the patient should arrange for someone to take them to the surgical facility, back home, and to spend the first night after surgery with the patient. When the patient arrives home from the surgical facility, they should go to bed and rest with the head elevated on 2-3 pillows.

He/she must keep the head elevated above the heart to minimize edema and swelling and also apply an ice pack to the neck which may also help decrease swelling.

The patient must avoid hot liquids for several days and a light, soft, and cool diet is recommended. The most important thing one can do after a tonsillectomy to prevent bleeding and dehydration is to drink plenty of fluids.

At times it may be very difficult to swallow. If the patient drinks, they will have less pain overall. Try to drink thin dilute, non-acidic drinks or frozen popsicles. Soft foods such as gelatin, ice cream, custards, puddings, and mashed foods are helpful to maintain adequate nutrition.

The patient will occasionally have throat tenderness with hot or spicy foods for up to 6 weeks postoperatively. Most patients require at least 7-10 days off from work or school. After 3 weeks, exercise and swimming can usually be resumed, but no diving for 6 weeks.