What is a Tonsillectormy and Adenoidectomy?
Tonsils are found in the back of the throat, flanking either side of the uvula (that thing that hands down in the center.) The adenoid is another tonsil-like structure up above the palate behind the nose. All three are part of the immune surveillance system, like lymph nodes. Fortunately, there is enough redundancy to this protective system that their removal has no consequences to health.
Removal of the tonsils and, often in kids, the adenoid is a simple procedure performed in the operating room. It takes 20-25 minutes, under a general anesthetic. Most of the time the patient goes home that same day. Occasionally, when there are special medical circumstances, the patient is very young, or known Obstructive Sleep Apneas is known to be present, an overnight stay is warranted.
The only real risk postoperatively is bleeding. This occurs around 1% of the time. It is not life threatening and usually resolves on its own. Occasionally a return trip to the OR is needed to stop a persistent ooze.
Recovery is the most difficult part of the process. Pain is significant after tonsillectomy and adenoidectomy. Control of the pain is central to recovery. Ibuprofen, in liquid form, is given every 8 hours. A liquid narcotic pain medicine, usually a combination of acetaminophen and hydrocodone, is taken every 4 hours when the ibuprofen is insufficient to adequately control the pain. Unfortunately, the throat hurts for 8-10 days. It is a long and difficult recovery.
Three things are key to recuperation: hydration, soft diet, and non-strenuous activity. Water, sports drinks, non-acidic juices, and even milk (no matter what the old wives’ tales say) are just fine. Popsicles are also excellent sources of fluid. Soft foods, like eggs, pudding, mac-n-cheese, and mashed potatoes are ideal. Stay away from crunchy and hard-edged foods. Finally, normal daily activity is encouraged. However, exercise and physical straining are to be avoided. Observation of all of these is important for the full 14 days after surgery, even if you are feeling better toward the end.