TONSILLECTOMY & ADENOIDECTOMY

A tonsillectomy is a procedure done to remove the tonsils.

Adenoidectomy refers to removal of the adenoids.

An adenotonsillectomy includes both of the above.

 

WHAT ARE TONSILS?

The tonsils are lymphoid tissue lying on either side of the back of the throat.

This tissue is similar to lymph nodes or ‘glands’ found in the neck.

They have a role in immune defence (defence against infection).

If they are recurrently or chronically infected they become a source of, rather than a defence against, infection.

 

WHY REMOVE TONSILS?

  • Recurrent/persistent infection causing sore throat, fever, halitosis and time lost from employment or studies.
  • Large size causing obstruction (a problem more common in children) with snoring or obstructive sleep apnoea.
  • Suspicion of tumour or malignancy (rare!).

 

GENERAL POINTS

  • Tonsillectomy is performed under general anaesthetic
  • Removal is performed through the mouth.
  • Tonsillectomy is usually a day stay procedure.

 

ADENOIDS

The adenoids are tonsil-like tissue in the back of the nose, up behind the roof of the mouth (palate).

If the adenoids are enlarged or chronically infected, they can also block the back of the nose. This will lead to nasal obstruction, mouth breathing, chronic nasal discharge, snoring and obstructive sleep apnoea.

The Eustachian tube opens near the adenoids.  If adenoids are enlarged or chronically infected, this may result in recurrent ear infections

Removal is indicated to relieve nasal obstruction, snoring, sinusitis and ear infections.

They are often large in small children and are commonly also removed with the tonsils (adenotonsillectomy).

 

AFTER SURGERY

  • Tonsillectomy is a painful operation!
  • Adenoidectomy is much less painful
  • Adequate pain relief is important.  A combination of paracetamol, anti-inflammatories, antibiotics and possibly other medications will be prescribed.  Pain usually “peaks” 5 – 7 days post-operatively. It is important to keep taking pain relief regularly for 10 days.  Pain is often referred to the ears.
  • There is no food restriction.  Adequate fluid intake (2-3 litres/day) is essential (avoid citrus juices as they sting).  Encourage chewing to lessen jaw muscle stiffness: chewing gum is helpful.
  • A yellow layer called slough is normal over the surgical site.  It usually separates around 5 – 7 days, sometimes with a small amount of blood.
  • At least a week and often up to 2 weeks off work or school is required to recover.
  • Avoid strenuous activity/sport for two weeks (lack of energy is common).

 

POSSIBLE COMPLICATIONS

  • Bleeding may occur for up to 2 weeks after the operation (most commonly after 5 – 7 days).

Most bleeding is brief and settles with bed-rest and sucking ice.

About 5% of patients will experience bleeding severe enough to be readmitted to hospital.

If bleeding is more than a cupful or lasts longer than 10 minutes, contact your family doctor, local              A & E clinic or Hospital Emergency Department.

  • Occasionally patients complain of an unpleasant or decreased taste when eating.  This usually resolves but may take weeks or months.
  • Vomiting is quite common in the first few hours.  If it fails to settle it may require further treatment.
  • Jaw damage which can restrict jaw opening is rare, unless there are pre-existing problems.  Please tell your surgeon & Anaesthetist if you have problems with your jaw.
  • There may be a change in the pitch of the voice.  This is rarely more than mild, and is usually temporary.
  • Damage to teeth may occur: please draw attention to caps on the front teeth.

YOUR APPOINTMENT

If you think that you or your child may required tonsillectomy and / or adenoidectomy, please call 031 201 3118 for an appointment.

A complete history will be taken, and a thorough examination completed. Further management will be in keeping with best ENT specialist practice guidelines.



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