Tonsillectomy

The tonsils are small, round pieces of tissue that are located in the back of the mouth on the side of the throat. Tonsils are thought to help fight infections by producing antibodies. Previously tonsils were thought to be a site of infection as opposed to a barrier against infection.

Routine tonsillectomies are rarely performed on children who suffer from swollen tonsils. It is only after recurrent bouts of acute tonsillitis or persistent ear infections that surgery (tonsillectomy) will be considered.

Common Symptoms
The symptoms of tonsillitis vary greatly depending on the cause of the infection, and can occur either suddenly or gradually. Each child may experience symptoms differently.  The most common symptoms of tonsillitis include:

• Sore throat and painful swallowing
• Fever >37 °C
• Headache
• Decreased appetite
• Generally feeling unwell
• Nausea and vomiting
• Stomach aches
• Visual redness or drainage in the throat

 

Each case is individual and a surgeon will assess the need for surgery, however common reasons include:

• Sleep apnoea or periods at night when your child stops breathing
• Trouble swallowing
• Bleeding from the tonsils that cannot be stopped
• Significant blockage of the nasal passage and uncomfortable breathing

Bad snoring, sinusitis, constant mouth breathing, frequent coughs & colds are not generally considered as a reason for tonsillectomy.

 

The Surgery
Tonsillectomy surgeries are done on an inpatient basis. This means that your child will have surgery and will stay in the Hospital for at least one night.

During the surgery, your child will be anesthetised in the operating room. The surgeon will remove your child’s tonsils and adenoids through the mouth.

In most cases, after the surgery your child will go to a recovery room to be monitored closely. After your child is fully awake and doing well, the paediatric nurse will bring your child back to St Theresa’s Ward.

 

Caring for your Child after Tonsillectomy
Tonsillectomy patients lack energy for several days and may be restless at night.  This will improve over the next five (5) to fourteen (14) days.

Following surgery:

• Increase fluid intake
• Use pain medication, as advised
• No heavy or rough play for a duration of time recommended by the surgeon

 

Breathing
Snoring and mouth breathing are normal after surgery because of swelling.  Normal breathing usually returns 10 to 14 days after surgery. 

Pain
Throat and ear pain can be severe after a tonsillectomy and may last for up to two weeks after surgery.  Ear pain is “referred pain” from the tonsil area and does not mean that anything is wrong with the ears. (Note: You can use paracetamol or ibruprofen to relieve pain, as appropriate).

Bad Breath
Scabs form where the tonsils were removed. They are thick and white and can cause bad breath.  Rinsing out the mouth with cool water can be done as long as the water can be spit out.  Avoid mouthwashes.

Diet
Patients need to drink a lot of fluids to help healing occur.  Avoid citrus, acid, sharp foods.  Avoid any foods that might scratch the through (e.g. crisps)

Activity
Limit activity to quiet play.  Avoid bike riding, rough play, running and skateboarding, as doing these can cause bleeding to occur.  We recommend children return to school no sooner than 14 days after a tonsillectomy. No swimming or vigorous activity for two weeks.

Fever
It is normal for tonsillectomy patients to run a slight fever (up to 37°C) for up to seven days after surgery.

Nausea and Vomiting
It is not unusual for a tonsillectomy patient to feel sick following a tonsillectomy. Introduce fluids slowly.   If the vomiting persists the day after surgery, contact your GP.

Voice Changes
There may be a nasal quality to the tonsillectomy patient’s voice after surgery.  This is normal and may last for several weeks.  Encourage talking, as it helps with the healing process.