Tonsil & Adenoid Surgery

What are tonsils and adenoids?

The tonsils and adenoids are part of a ring of lymphoid tissue in the pharynx that helps fight bacteria and infections. The tonsils are the two masses in the back of the throat. The adenoids are above the tonsils in the back of the nasopharynx behind the nose. These are not seen easily without special instruments (a mirror or a scope through the nose).

Why would I ever want to remove tissue that helps me fight infection?

Most of the time, the tonsils and adenoids do a good job. Problems arise when these are chronically infected or interfere with breathing, swallowing or sleeping. Abscesses around the tonsils can form and cause acute swelling, pain, and difficulty swallowing. Some people have recurrent tonsil infections separated by periods of being well. Others have chronic tonsillitis with constant debris coming from the tonsils or bad breath that goes away for a short time with antibiotics or mouth gargles and then comes right back. If chronically infected, the adenoids can also be a reservoir for bacteria that can then block the Eustachian tube or climb up the Eustachian tube into the middle ear and cause constant ear infections or fluid in the middle ear.

The adenoids can sometimes be so large as to completely block the back of the nose and make it very difficult to breathe through the nose at all. Enlarged tonsils can sometimes interfere with breathing and sleep which leads to obstructive sleep apnea.

Rarely, tumors can grow from the tonsils or nasopharynx. This needs to be evaluated and biopsied right away.

What to expect at surgery for the tonsils and adenoids?

  • Do not take any aspirin or ibuprofen containing products for 2 weeks before and after surgery – they tend to increase bleeding.
  • Soft foods for 2 weeks after surgery. Avoid hot, spicy foods, tomato sauces, and orange juice.
  • Increase fluid intake. Frequent sips of fluid are best supplemented with ice cream, jello, custards, popsicles, ice chips, etc.
  • Most discomfort after tonsillectomy is due to muscle soreness. First swallows in the morning are always the worst. They may be referred to the ear as an “earache.” This usually occurs on the second postoperative day.
  • The more the throat is used for swallowing, the less is the overall discomfort and the quicker the healing.
  • Between the 5th and 10th postoperative day, the scabs in the throat (these are white in color) come off the throat surface. In some cases, bleeding occurs as it does with the lifting of a scab anywhere. Do not be alarmed. If it occurs, gargle with ice water. Keep the head elevated in a comfortable semi-upright position, suck on ice chips intermittently. However, if bleeding persists, please call the office or go to the emergency room.
  • Adenoidectomy alone does not cause the same throat soreness and usually has less pain. Avoidance of aspirin and ibuprofen is still necessary.

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