Tonsillectomy/Adenotonsillectomy

Tonsillectomy or Adenotonsillectomy Patient Resource

This resource will help you understand the process of going through a tonsillectomy or adenotonsillectomy.
The video below will give an overview of what to expect.

Tonsillectomy/Adenotonsillectomy Overview Video

Text Version

This introduction will give you an overview of your upcoming tonsillectomy or adenotonsillectomy. A tonsillectomy is a surgical procedure where the tonsils are removed. An adenotonsillectomy means that both the tonsils and the adenoids are removed.
Your tonsils are located beside your tongue. Your adenoids are hidden from view at the back of the nose. The tonsils and adenoids are part of your body’s immune system. However, sometimes our tonsils and adenoids can cause us problems. The tonsils or adenoids may have to be taken out when they are enlarged, or frequently infected. These are two of the many reasons you may need this surgery.
On the day of surgery, you will arrive at the hospital. The person who comes with you will stay in the waiting room. Depending on the hospital and age of the child, a parent may bring their child into the operating room. Next, you will go into an operating room and lie down on an operating bed. The anaesthesiologist, who is a specialist doctor, will put you to sleep so you don’t feel anything during surgery.
The surgeon will open your mouth and will locate where the tonsils meet the side of the throat. A special tool is used to remove the tonsils. If the adenoids need to be removed, they are taken out before the tonsils. Usually, you do not need stitches.
Once the surgery is done, the anesthesiologist will wake you back up. You will be moved to the recovery room. Some patients, such as young children, will stay in the hospital overnight. Many patients go home the same day.
After surgery, your throat will be sore, and this can last for 1-2 weeks. The area where your tonsils used to be may turn a white color. The scabs that form should come off naturally in small or large pieces four to ten days after surgery.
If you are worried about any bleeding, or have any other concerns, it is important that you, or your parents, talk to your doctor, or go to the nearest Emergency room. It is also very important that you stay well hydrated after your surgery. Please look at our website for additional information. Good luck during your upcoming surgery!

Anatomy of your Tonsils and Adenoids

A tonsillectomy is the removal of the tonsils. An adenotonsillectomy removes the tonsils and the adenoids. Tonsils and adenoids are part of the body's defense system. Although healthy tonsils and adenoids offer disease-fighting (immuno) protection, diseased tonsils and adenoids are less effective at serving their immune functions. Removing the tonsils or adenoids does not make you more likely to get an infection.

Tonsils and Adenoids Illustrations

Tonsils
Adenoids

The tonsils are small pieces of tissue at the back of the mouth, beside the tongue. There is one tonsil on either side of the throat.

Adenoids are lumps of tissue at the back of the nose. You cannot see your adenoids when looking in the mouth.

Why is a Tonsillectomy/Adenotonsillectomy Needed?

Five most common reasons why you may need your tonsils and/or adenoids removed.

Recurrent Tonsillitis

Someone who gets bacterial tonsillitis multiple times in a year may need to have their tonsils removed to prevent against another infection.

Learn More at emedicinehealth.com

Obstructive Sleep Apnea

Difficulty breathing at night can be another problem for some people with swollen tonsils. This can also leave a person feeling tired and run down during the day.

Learn More at aboutkidshealth.ca

Swollen Tonsils/Adenoids

Swollen tonsils or adenoids make it hard to breath or swallow due to upper airway obstruction.

Malignancy

If there is a concern for malignancy, a tonsil biopsy or tonsillectomy may need to be performed.

Learn More at ent.about.com

Peritonsillar Abscess

This condition causes individuals to have severe throat pain, fever, drooling, foul breath and difficulty opening of the mouth. The tonsils are often removed in cases of recurrent peritonsillar abscesses.

Learn More at mountsinai.org

Recurrent Tonsillitis

Obstructive Sleep Apnea

Swollen Tonsils/Adenoids

Malignancy

Peritonsillar Abscess

Recurrent Tonsillitis

Someone who gets bacterial tonsillitis multiple times in a year may need to have their tonsils removed to prevent against another infection.

Learn More at emedicinehealth.com

Obstructive Sleep Apnea

Difficulty breathing at night can be another problem for some people with swollen tonsils. This can also leave a person feeling tired and run down during the day.

Learn at aboutkidshealth.ca

Swollen Tonsils/Adenoids

Swollen tonsils or adenoids make it hard to breath or swallow due to upper airway obstruction.

Malignancy

If there is a concern for malignancy, a tonsil biopsy or tonsillectomy may need to be performed.

Learn More at ent.about.com

Peritonsillar Abscess

Learn More at mountsinai.org

Prepare

The following section has information to help make the day of surgery run smoothly.

Information Your Doctor Will Ask

All medications, including over-the-counter drugs and dietary supplements, taken regularly.
Personal or family history of negative reactions to anesthetics.
Known allergy or other negative reactions to medications, such as antibiotics.
Personal medical history.

Questions To Ask Your Doctor or the Hospital Staff

What are my dietary restrictions before surgery?
When should I arrive at the hospital? Where do I need to check in?
Can I take other prescription medications in the days before surgery?
What is the expected recovery time?
What restrictions to activities or diet should I expect during recovery?

Aspirin

Do not take aspirin or other medications containing aspirin for at least ten days prior to surgery.

Eating and Drinking

Food and drinks shouldn't be consumed before the operation. The doctor or nurse will tell you how far before surgery to stop eating or drinking as times may vary.

Transportation

Make arrangements for a ride to and from the hospital.

Prepare for recovery

Plan for ten days to two weeks or more of recovery time.

Information Your Doctor Will Ask

Questions To Ask Your Doctor or the Hospital Staff

Aspirin

Eating and Drinking

Transportation

Prepare Time for Recovery

Information Your Doctor Will Ask

All medications, including over-the-counter drugs and dietary supplements, taken regularly.
Personal or family history of negative reactions to anesthetics.
Known allergy or other negative reactions to medications, such as antibiotics.
Personal medical history.

Questions To Ask Your Doctor or the Hospital Staff

What are my dietary restrictions before surgery?
When should I arrive at the hospital? Where do I need to check in?
Can I take other prescription medications in the days before surgery?
What is the expected recovery time?
What restrictions to activities or diet should I expect during recovery?

Aspirin

Do not take aspirin or other medications containing aspirin for at least ten days prior to surgery.

Eating and Drinking

Food and drinks shouldn't be consumed before the operation. The doctor or nurse will tell you how far before surgery to stop eating or drinking as times may vary.

Transportation

Make arrangements for a ride to and from the hospital.

Prepare for recovery

Plan for ten days to two weeks or more of recovery time.

Surgery Day

This section provides more information about the day of surgery. There may be some variation from different hospitals and surgeons.

Steps to the Operating Room

On the day of surgery you will arrive at the hospital.
The person who comes with you will stay in the waiting room.
A parent may bring their child into the operating room.
You will be provided with a hospital gown to change into.
Next, you will go into an operating room and lie down on an operating bed.

Anaesthetic

The anaesthesiologist, who is a specialist doctor, will put you to sleep so you don't feel anything during surgery.

The Surgery

The surgeon will open your mouth and will locate where the tonsils meet the side of the throat. The tonsil is grasped and pulled towards the middle of the mouth. A special tool is used to remove the tonsils. If the adenoids require removal, they are usually removed prior to the tonsils. Usually, stitches are not needed.

Leaving the Hospital

Once the surgery is done, the anesthesiologist will wake you back up. You will be moved to the recovery room. Some patients, such as young children, will be kept in the hospital overnight. Many patients leave the same day.

Steps to the Operating Room

Anaesthetic

The Surgery

Leaving the Hospital

Steps to the Operating Room

On the day of surgery you will arrive at the hospital.
The person who comes with you will stay in the waiting room.
A parent may bring their child into the operating room.
You will be provided with a hospital gown to change into.
Next, you will go into an operating room and lie down on an operating bed.

Anaesthetic

The anaesthesiologist, who is a specialist doctor, will put you to sleep so you don't feel anything during surgery.

The Surgery

Leaving the Hospital

Risks/Consent Discussion

Prior to the procedure, you and your doctor will have discussion regarding possible surgical risks. Some of these risks are listed below.

Bleeding

Bleeding may or may not require another surgery. It usually occurs early (first 24-48 hours), or late (after 7-10 days). Rarely, it can be life threatening. This risk is more likely for patients with a past history of bleeding disorders.

Infection

If an infection occurs, antibiotics may be prescribed after surgery.

Dental Trauma

This can occur due to the instruments used during surgery.

Post-Obstructive Pulmonary Edema

This is a very rare condition. It causes breathing difficulty and requires medical attention right away.

Ongoing Infections

Throat infections are still possible, even after the tonsils and/or adenoids are removed.

Bleeding

Infection

Dental Trauma

Post-Obstructive Pulmonary Edema

Ongoing Infections

Bleeding

Infection

If an infection occurs, antibiotics may be prescribed after surgery.

Dental Trauma

This can occur due to the instruments used during surgery.

Post-Obstructive Pulmonary Edema

This is a very rare condition. It causes breathing difficulty and requires medical attention right away.

Ongoing Infections

Throat infections are still possible, even after the tonsils and/or adenoids are removed.

After Surgery

This section provides information regarding recovery from surgery.

When to Seek Emergency Attention

Bleeding- You may see small specks of dark blood from the nose or in the saliva but any bright red blood requires a trip to the emergency room for prompt evaluation and treatment. Vomiting blood also needs emergency attention. Surgery to stop the bleeding may be necessary.
Fever- Call your doctor if there is a fever of 102 F (38.9 C) or higher.
Dehydration- Call your doctor if you observe signs of dehydration, such as reduced urination, thirst, weakness, headache, dizziness or lightheadedness. Common signs of dehydration in children include urinating fewer than two or three times a day or crying with no tears.
Breathing Problems- If you or your child is having difficulty breathing, get emergency care immediately.
No Urination- Not being able to urinate within the first 12 hours after the operation requires medical attention.
Chest Pain, Weakness or Numbness- Chest pain, weakness or numbness in the face or limbs requires medical attention.

Pain Management

Pain is normal in the throat up to two weeks after surgery. Take pain medications as directed by your surgeon or the hospital staff. You can also use a machine called a humidifier. This machine makes the air moist with a cool mist. Place it beside the bed.

Scabbing

The area where your tonsils used to be may turn a white color. This is normal and does not mean that there is an infection. The scabs that form may continue to scab and re-scab. They should come off naturally in small or large pieces four to ten days after surgery.

Eating and Drinking

It's important to get plenty of fluids after surgery to avoid dehydration. Water and ice pops are good choices and they may also help prevent bleeding. Bland, soft foods that are easy to swallow, such as applesauce or broth, are the best choices immediately after surgery. Foods such as ice cream and pudding can be added to the diet if they're tolerated. Foods that are easy to chew and swallow should be added to the diet as soon as possible. Avoid acidic, spicy, hard or crunchy foods as they may cause pain or bleeding. By 10-14 days, a regular diet should be resumed.

Rest

Rest is important for several days after surgery. Strenuous activities such as running and biking should be avoided for two weeks after surgery. Talk to your doctor about any activities that should be avoided.

Breath

You or your child's mouth may smell different for two weeks after the operation. Rinse the mouth regularly with water/salt water and gently brush the teeth.

Voice

If the adenoids were taken out, it may sound as if you or your child is talking through the nose. This is normal. This may last for a few weeks or up to three months. if the adenoids were very large. If you still have any concerns, contact your doctor.

Returning to School/Work

You or your child should be able to return to work or school after resuming a normal diet, sleeping normally through the night and not needing pain medication. This should be 7-10 days after the operation. Do not go on long trips out of town during this period. Your doctor/health care team will arrange a follow-up appointment with you after surgery to assess your recovery.

Pain Management

Scabbing

Eating and Drinking

Rest

Breath

Voice

Returning to School/Work

Pain Management

Scabbing

The area where your tonsils used to be may turn a white color. This is normal and does not mean that there is an infection. The scabs that form may continue scab and re-scab. They should come off naturally in small or large pieces four to ten days after surgery.

Eating and Drinking

Rest

Breath

You or your child's mouth may smell different for two weeks after the operation. Rinse the mouth regularly with water/salt water and gently brush the teeth.