Tonsillectomy

 The operation of removing tonsils is called tonsillectomy.  The usual indication for this operation is in children or adults suffering from recurrent acute or chronic tonsillitis, but occasionally when the tonsils are large, they are removed to improve breathing or swallowing.

The operation

Tonsillectomy is carried out under a general anaesthetic, and usually takes about 30 minutes.  The operation is all carried out through the mouth, and there are no external incisions.

Length of stay in hospital

Tonsillectomy is usually carried out as a day-case procedure, but occasionally it may be necessary to stay in hospital overnight.

Post-operative symptoms

a) Pain

The throat will feel sore for a few days after the operation, and it is common to get discomfort in the ears, as well as the throat.  This discomfort varies in intensity, and often gets worse on about the 4th or 5th day before beginning to improve on about the 7th – 10th post-operative day.  It is important to persevere with a normal diet and plenty of fluids will help to relieve the soreness and speed the recovery.  Dehydration makes the situation worse.

Pain relief is managed by a combination of painkillers, including Diclofenac (a non steroidal anti-inflammatory drug), Paracetamol and Codeine Phosphate.  In addition, a painkilling spray, Difflam, is occasionally used.  Regular use of all the painkillers leads to better control of pain in the post-operative period and is recommended.  If the painkillers are taken half an hour before expected meals, it can help reduce the discomfort and improve the ability to eat.  

b) Post-operative healing

The tonsil beds heal by ingrowth of new lining from the edges.  This takes about 7 to 10 days to be completed, and during this time the tonsil beds are covered with a most unpleasant white/grey slough.  This is the usual appearance and does not indicate that there is any infection.

c) Post-operative bleeding

It is common to experience a small amount of bleeding as the healing slough comes away.  However, rarely, during the first post-operative week, a blood vessel may re-open in the tonsil bed and start to bleed.  If this happens and it does not stop quickly, it may be necessary to return to hospital to have it stopped.

If you or anybody in your family has problems with abnormal bleeding, please inform us.

Post-operative care

Once you are home, you should take things gently for the first 3 or 4 days to help prevent the risk of bleeding.  You should avoid anybody who has a cough or cold, as it is important not to get a secondary infection in the throat.

After the first 3 or 4 days, you should gradually increase your activity with the intention of returning to normal after 7 to 10 days.

If you begin to feel unwell or suspect a temperature, this might indicate an infection, in which case antibiotics may be required.

Length of time off work/school

It is best to avoid work/school for at least 12 days after the operation.  You should also avoid sports and swimming for this period of time, and then restart them gently.

Possible complications of tonsillectomy

Tonsillectomy is usually a straightforward and safe procedure but as with any operation there is always the small risk of a complication.

a) General Anaesthetic

General anaesthetics are very safe in this day and age. The Anaesthetist will visit you / your child on the ward before the operation and discuss the risks of the anaesthetic and any other concerns with you.

b) Bleeding 

There is a very small risk of bleeding from the throat in the first post-operative week. This will nearly always stop spontaneously after a few minutes however very rarely it might be necessary for you / your child to be readmitted to hospital to stop the bleeding.

c) Infection

Infection is rare after tonsillectomy. The white appearance often seen in the throat after tonsillectomy is part of the normal healing process and not an infection.

d) Injury to the teeth, mouth, throat or tongue

Very rarely during tonsillectomy the teeth, mouth, throat or tongue can be injured.

e) Change of taste

Very rarely a change or loss of taste or numbness of the tongue is noticed after tonsillectomy.

If you have any concerns once you have returned home, do not hesitate to telephone for advice to one of the following numbers:
Children &Young Persons Unit: 0117 9804000 ext 4544
Level 4 ward Tel: 0117 9804000 ext 4283
Spire Bristol Hospital Tel: 0117 9804000
or myself for advice via my PA Mrs Lorraine Goulder Tel: 0117 9804050