Tonsillectomy is a very common procedure performed in both children and adults. It may be performed alone or with an adenoidectomy.
Before the Surgery
Please read this page and the Royal Australasian College of Surgeons’ information sheet (“Surgical removal of the tonsils and adenoids”) so you understand the procedure, the benefits and risks associated with this procedure and the expected outcomes of surgery. The information sheet will be given to you when booking the operation.
As your child will be fasting prior to surgery, please make sure that he / she drinks plenty of fluids and has a good meal before his/her fast begins.
Accompanying children into the operating room
One parent is permitted to accompany their child into the operating theatre until he / she is asleep. It is important to remain calm and positive since children can be affected by their parents’ energy.
You will then be escorted out of the theatre to a waiting area while I perform the operation and you will be contacted by phone once your child is fully awake in the recovery room.
After the Surgery
If this process seems like it is taking longer than you expected, please do not worry – the experienced recovery nurses will often let your child doze and “sleep off” the anaesthetic until he / she is ready to wake up.
Your child should not be in pain immediately after the surgery as I will have injected local anaesthetic into the operation site, and my anaesthetist will have given strong pain relief during the procedure. Children may still cry afterwards as they can be disorientated, and this is a new experience for them in an unfamiliar environment.
Drip (intravenous cannula)
Your child will wake up with a drip in one of their hands. The needle of the drip has been removed and what is left is simply a plastic tube to deliver further fluids or medications through this route – your child can still move and use that hand gently.
The drip will be removed by nursing staff before your child is discharged from the hospital.
Avoid hot foods and drinks for 2 weeks as these can increase the risk of bleeding. Cooked meals are fine, but let the food cool down before eating it. Apart from the above, give your child whatever their favourite foods and drinks are!
Citrus (acidic) drinks such as orange juice may cause some throat discomfort but are not dangerous to have. Often milk, ice cream and yoghurt are soothing for the throat.
Do not worry if your child does not feel like eating large amounts after the surgery – this may relate to the anaesthetic on the first day, and some throat discomfort on the following days. It is more important that your child is drinking good amounts of fluids. Apart from preventing dehydration, keeping the throat moist by drinking helps prevent pain associated with a dry throat. Remember, flavoured icy poles and ice blocks are excellent at soothing the throat and they count as fluids!
Alternating Panadol with Nurofen is very effective. Optimal pain control is achieved by giving these at regular intervals, even if your child does not seem to be in pain. Panadol should be given every 6 hours and Nurofen can be given every 8 hours if required. There is excellent evidence showing that Nurofen does not increase the chance of bleeding after this procedure and can be used safely.
Stronger medication will also be prescribed for your child and can be taken with the Panadol and the Nurofen.
Your child will be given 2 weeks off school/sport. This is because there is about a 4% chance of bleeding in the first 2 weeks after the operation, and physical exertion will increase this risk. If your child coughs up more than a teaspoon of fresh red blood, you need to go to your nearest hospital with an Emergency department. You may need to call an ambulance to take you there if you are worried. The hospital will then contact me.
The recovery from tonsillectomy can be like a “roller coaster” with good days and bad days; your child might feel like he/she is getting better and then feel more discomfort between about days 5 and 10.
Your child may experience some ear pain following tonsillectomy – this is referred pain from a shared nerve supply and is very common. Following the pain relief regime above should assist with this.
If you look in the back of your child’s throat you may see it looks white/black/yellow-green – this is normal and part of the healing process; it does not signify infection. Once the throat has finished healing it will look exactly like the rest of the mouth.
Your child’s voice may sound slightly different while the palate and throat heal. This is generally temporary and returns back to normal once the discomfort resolves. Bad breath is also common after tonsillectomy - this improves after about 2 weeks.
Don’t worry if your child is still snoring after the procedure – it takes a couple of weeks for the swelling in the back of the nose (if adenoidectomy was also performed) and throat to go down before snoring improves.
Please do not make any travel plans during the first 3 weeks after tonsillectomy.
I will inform you when you need to see me following the procedure – please contact my rooms to schedule this appointment.