Tonsillectomy & Adenoidectomy | Best ENT Specialist in India
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Tonsillectomy & Adenoidectomy

What is a tonsillectomy?

Surgical removal of tonsils is called tonsillectomy. Tonsils are located in the back of the throat and are a part of our immune system that defends the body from infections. Tonsillectomy is usually performed on children.

Just to reassure, a tonsillectomy has no adverse effect on the body’s immunity.  

Why is a tonsillectomy required?

A tonsillectomy can be done for quite a few reasons. The two major reasons for it are:

  • The patient is extra susceptible to recurring tonsil infections (medically called tonsillitis) that keep coming back and leaving the tonsils inflamed and swollen most of the time.
  • The tonsils are enlarged and that’s creating breathing problem during sleep resulting in frequent snoring.

How does an ENT surgeon perform a tonsillectomy?

A tonsillectomy is performed under general anaesthesia and takes about 20 - 30 minutes. There are several ways of conducting a tonsillectomy.  In the most common method, the surgeon removes tonsils using a scalpel. It is called a ‘cold knife steel dissection’.

Other tonsillectomy methods include using coblation, radio frequency ablation, or CO2 laser to remove tonsils.

Read more about these surgical devices here: http://www.raosentcare.com/raos/equipment

As a tonsillectomy is done with the patient under general anaesthesia i.e. total body sedation, the patient is asleep all through the procedure and wakes up in the recovery room with tonsils safely removed. While the medical staff monitors the patient for a few hours after the surgery, most patients are discharged from the hospital the very same day.

What are the pre-operative instructions to be followed before undergoing tonsillectomy?

  • The patient should have no food at all from six hours prior to the surgery.

  • Make sure you bring the hospital file with you at the time of the check-in for surgery duly including all required test reports such as the major surgical profile, pre- anaesthetic check up sheet, radiological investigation films and reports (X-ray, CT scan, MRI, PET scan etc.) and any others investigations advised by your ENT surgeon. We advise you to ready this file a day before the surgery.

  • Bring along any prescription or non-prescription medicines the patient is taking (in original packaging/bottles) when you check in for surgery the next morning. If your patient is using an inhaler or a breathing device, bring along that too.

  • If your infant is undergoing tonsillectomy, bring along special formula/breast milk for post-operative feeding.

  • A child patient can bring along a favourite comfort item - blanket, stuffed animal, or pacifier etc. – which will be allowed inside the Operating Room and the Post Anaesthesia Care Unit (PACU)/ Recovery Room. Children can also bring along movies, books or games if they will be staying at the hospital overnight or through the day.

  • If your child is undergoing tonsillectomy, please be prepared to dedicate the entire day to your child’s surgery and recovery. We request you to make due arrangements for your other children at home well in advance.  It is essential that we as surgeons, and you as parents, can together devote complete attention to the child undergoing surgery.

  • Please ensure that you report at the hospital at least three hours prior to the surgery’s scheduled timing.

  • Report at the reception desk in time and the hospital staff will guide you through the next steps.

  • If you have felt any changes in the patient’s physical condition such as cough, cold, fever or throat pain, be sure to mention it to your doctor and anaesthetist. If the patient is allergic to any drugs, be very sure to mention that as well.

Please read the following information carefully to get further clarity on the pre-operative instructions including special instructions for patients with diabetes, respiratory or cardiac problems.

What are the post-operative instructions that need to be followed after a tonsillectomy?

  • The patient will not be allowed any drink or food till 4-5 hours after the surgery. After the surgical staff gives the go-ahead, you can give them cold water to sip.

  • It is recommended to give cold soft diet for the first day once every hour. Smooth textured ice creams such as vanilla and strawberry and non-aerated cold drinks such as milk shakes are a good idea. The sooner and the more the patient eats and chews and drinks plenty of fluids, the faster will be the recovery.

  • After the patient eats or drinks anything, he/she should gargle their mouth with plain water that should then be spit out.

  • Some (not all) patients feel pain after tonsillectomy. While mostly it is in throat, sometimes the pain can also be felt in the ears, jaws or neck that can last for up to a fortnight after the surgery. Here are a few ways to reduce pain, boost recovery and prevent complications:

  1. Medications: The patient should use pain medications as prescribed by the operating surgeon.

  2. Fluids: The patient should be given plenty of fluids like cold water to drink. Licking ice popsicles is also a good idea.

  3. Food: The patient should eat only non-spicy and easy-to-swallow food. Spicy, hard or crunchy items are to be avoided totally for a while. After 3 days, the move to normal food can be made by and by.

  • Rest: The patient should take a week’s bed rest. School/work can be resumed once normal diet is resumed and the patient can sleep through the night comfortably without pain medication.  The patient can be taken off bland diet from third day and slowly transitioned to a normal diet.

  • The site of tonsils will have some discolouration that will take about 3 to 4 weeks to disappear.

  • The patient may snore and breathe through the mouth due to swollen throat which will take 10-14 days to subside.

  • The patient can have low fever for 2-3 days after the surgery. Contact the doctor if the fever crosses 101ºF.

  • Strenuous exercise, running and bike riding are not allowed for a fortnight after tonsillectomy.

What will be the schedule of the patient’s post-operative follow up visits after getting a tonsillectomy?

The patient will be required to come for post-op check-ups in the OPD on day 1, day 3, day 7, day 14, day 21, and day 28 after the surgery. Please bring along the hospital file, prescription and non-prescription medications in their original packaging on these visits.

When should I contact the doctor urgently after the tonsillectomy?

  • If there is bright red bleeding from the mouth.

  • If fever climbs higher than 101 F and does not get better with medication,

  • If there is excessive pain.

  • If there is dehydration which will show up as dry mouth, tearless crying, no urine output for over a period of 4-6 hours and sunken eyes etc
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