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TONSILLECTOMY
WHAT ARE TONSILS? The tonsils are two pads of tissue located on either side of the back of the
throat. Tonsils can become enlarged in response to recurrent tonsil infections or Strep throat. They can also REASONS FOR TONSILLECTOMY:
INFECTION—Recurrent tonsil infections or Strep throat despite antibiotic therapy.
UPPER AIRWAY OBSTRUCTION—Enlarged tonsils can block the airway and cause PREOPERATIVE CARE: No aspirin products (including Pepto-Bismol) or products containing Ginko
Biloba or St. John's Wort should be taken for 2 weeks prior to surgery. No ibuprofen products (Children's Advil, Children's Motrin) or anti-inflammatory medications (Naprosyn, Aleve, Celebrex) should be given for one week prior to surgery. None of these products should be given for 2 weeks after surgery. Acetaminophen (Tylenol) may be given as well as over-the-counter cold medications and antibiotics. Please notify your doctor is there is a family history of bleeding tendencies or if the patient tends to bruise easily.
THE SURGERY: Tonsillectomy is performed under general anesthesia is frequently performed with an
adenoidectomy. The surgery takes less than 10 minutes. The child remains at the surgery center for a few hours after outpatient surgery or overnight if your doctor has requested this.
POSTOPERATIVE CARE: It takes most children 7 days to recover from a tonsillectomy. Some children
feel better in just a few days and other children take as many as 14 days to recover.
NAUSEA AND VOMITING: Some children experience nausea and vomiting from the general anesthetic.
This usually occurs during the first 24 - 36 hours after surgery. If there is nausea or vomiting, please use the anti-nausea medication if this was prescribed and call the office nurse if this does not help.
FEVER: A low grade fever is normal for several days after surgery and should be treated with
acetaminophen or acetaminophen with codeine, whichever your doctor has prescribed. Please call the office nurse if the temperature is over 102°F.
PAIN: Most children experience a fair amount of throat pain after surgery. Many children also complain of
earache. The same nerve that goes to the throat goes to the ears and stimulation of this nerve may feel like an earache. Some children also complain of jaw pain and neck pain. This is from positioning in the operating room. Many children have trouble eating, drinking and sleeping because of pain. Severity of pain may fluctuate during recovery from mild to very severe and pain may last up to 14 days. It is common for the pain to get worse for the first few days after surgery.
PAIN CONTROL: Please medicate your child every 4 hours for pain with acetaminophen or
acetaminophen with codeine, whichever your doctor has prescribed, but do not exceed 5 doses in a 24 hour period. An ice collar to the neck, chewing gum, and a humidifier in the child's room may also help relieve pain. Acetaminophen also comes in a suppository form as well as a form called "Tylenol Melt Aways". Try not to take the pain medication on an empty stomach as this can lead to nausea.
BREATHING: Snoring and mouth breathing are normal after surgery because of swelling. Normal
breathing should resume 10-14 days after surgery.
SCABS: A membrane or scab will form where the tonsils were removed. This looks like two separate scabs
or sometimes the whole back of the throat is scabbed. The scabs are thick and white and cause bad breath. This is normal. The scabs usually fall off a little at a time 5 - 10 days after surgery and are swallowed.
BLEEDING: If there is any bleeding from the mouth please call the office nurse or page the ENT doctor
on-call. Bleeding usually means the scabs have fallen off and this might need immediate attention. Gargling and spitting ice water for several minutes often slows or stops the bleeding.
SPEECH: If tonsils are very large, the sound of the voice may be different after surgery.
DRINKING: The most important part of recovery is to drink plenty of fluids. Some children do not want
to drink because of pain. Offer and encourage fluids frequently such as juice, soft drinks, popsicles and Jello. After 24 hours, milk products such as pudding, yogurt and ice cream may be offered. Please call the office nurse if you are worried that your child is not drinking enough or if there are signs of dehydration (urination less than 2 times per day, crying but no tears). Some children may have a small amount of liquid come out of the nose when they drink. This should stop a few weeks after surgery.
EATING: There are no food restrictions after surgery. The sooner eating and chewing are resumed, the
quicker the recovery. Many children are reluctant to eat because of pain. As long as your child is drinking well, don't worry so much about eating. Many children are not interested in eating for up to a week. Some children lose weight, which is gained back when a normal diet is resumed.
ACTIVITY: Most children rest at home for several days after surgery. Activities may be resumed with no
restrictions if your child feels up to it. Generally, children may return to school when they are eating and drinking normally, off all pain medication, and sleeping through the night. This is 7 days on average and can be less or more for some. Even though children may be feeling well, they are at risk for bleeding for up to 14 days after surgery. Keep this in mind as your child is resuming normal activities and do not travel out-of-town for 2 weeks after surgery.
FOLLOW-UP: Please follow up at 1 week and again at 1 month after surgery. If there are problems or
questions before that time, call the office nurse.
Matt Robertson, MD
Alpine Ear, Nose, & Throat
1120 East Elizabeth St. #F-101
3820 North Grant Ave.
Fort Collins, CO 80524
Loveland, CO 80538
970-221-1177
970-593-1177
RECOMMENDED DOSAGE OF PAIN MEDICATIONS (EVERY FOUR HOURS)
MILD PAIN
SEVERE PAIN

Source: http://www.alpineent.com/doctors_and_staff/matt/dr_robertson_tonsillectomy.pdf