TONSILLECTOMY AND ADENOIDECTOMY (T & A)

The tonsils and adenoids are found near the entrance to the breathing passages. They are part of the body's immune system to protect against nose and throat infections. The two tonsils are located in the back of the throat. They look like reddish, oval-shaped masses on either side of the throat. The adenoids are high in the throat behind the nose and the roof of the mouth. The adenoids cannot be seen through the mouth without special instruments.

In some people, especially children, the tonsils and adenoids themselves can begin to develop repeated infections. These infections can involve the throat or ears. Sometimes an abscess may develop near the tonsils. The tonsils and/or the adenoids can also become enlarged enough to cause breathing or swallowing problems. Breathing obstruction causes snoring and disturbed sleep patterns. This can lead to daytime sleepiness in adults and behavioral problems in children.

A tonsillectomy and adenoidectomy, or T & A, is an operation to remove the tonsils and adenoids. The two main reasons to do this surgery are recurrent infections despite taking antibiotics and difficulty breathing due to enlarged tonsils and/or adenoids.

Once it has been decided that T & A is necessary, the patient should be told what to expect before and after surgery. Children should be given explanations in a way so that they understand exactly what is going to happen. Parents should plan on spending as much time as possible with the child before and after surgery to offer comfort and support.

The surgery is usually done at an outpatient facility under general anesthesia. A T & A is usually not a high-risk procedure. The risks of concern are problems with anesthesia or bleeding after the surgery. The patient usually returns home the same day of the surgery. Only rarely are patients observed overnight in the hospital.

Before the surgery, the surgeons will ask about any current health problems and if the patient is taking any medications. The doctor will also want to know about any previous problems with anesthesia. A blood test and a urine test may be required before surgery. An adult may also need some additional tests. At least 2 weeks before the surgery it is important not to take aspirin or other medications containing aspirin. This will help decrease the risk of bleeding after the surgery.

The surgeon will give specific instructions to follow for 12 hours prior to the scheduled surgery. Generally, this includes not having anything to eat or drink during this time. Chewing gum, using mouthwash, throat lozenges or brushing the teeth with toothpaste is also not permitted. This helps to prevent any vomiting during the surgery while under anesthesia.

When arriving at the surgery center, the nursing staff will help the patient get ready for the surgery. The anesthesiologist will usually spend some time with the patient. The patient will then be taken to the operating room and a needle will be put in a vein to give the anesthetic and fluids during and after surgery.

After the operation, the patient is taken to the recovery area to be closely observed until discharge. Recovery times vary for each person. It ranges from 2 to 10 hours.

Once the patient is at home, a sore throat and ear pain can be expected for about a week. Sucking on a Popsicle, eating ice cream, Jell-O, or drinking cold liquids may provide some comfort. Pain relieving medication is usually recommended. During this time, eating soft, easy to swallow food and drinking cold liquids frequently is helpful. A cool mist humidifier can also help increase comfort. Since the throat is very susceptible to infection after surgery, it is a good idea to stay away from groups or ill people for 7 days.

When at home, call your provider immediately if:

any bleeding occurs from the mouth or nose
severe difficulty swallowing prevents taking fluids
vomiting lasts more than 12 hours
pain is not relieved by medication or
fever of 102 degrees Fahrenheit (38.9 degrees Centigrade) or higher

It can take 2 weeks for a complete recovery after a T & A, but fewer throat infections and easier breathing can usually be expected after the surgery and make all the discomfort worthwhile.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File EARN4450.RF2 VRS# 4450 Data Version 7.0