Ogden Clinic | Specialties

Questions and Answers: Tonsils and Adenoids

What are tonsils and adenoids?

Tonsils are paired lymph nodes that sit in the back of the throat, one on each side. Adenoids are the same lymphatic tissue that sit behind the nose against the back wall of the throat. The function of both tonsils and adenoids is to trap infection. Realize that each person has hundreds of other lymph nodes in the head and neck area.

How do tonsils cause problems?

Because tonsils are good at what they do, trapping infection, they can become chronically infected with bacteria. If this happens, a person may suffer with a sore throat and have to be treated with antibiotics. Also, tonsils can get larger in attempting to fight bacteria. This may cause blockage in the throat especially at nighttime. This can range in severity from mild (snoring) to severe (stoppage of breathing-apnea).

What is tonsillectomy?

Tonsillectomy involves the removal of the tonsils surgically. It is performed under general anesthesia and takes approximately 30 minutes. The tonsils are dissected out of the throat using an electrocautery to cauterize the blood vessels. The patient then will be observed by nurses in the recovery room from 4-6 hrs. Nowadays, most tonsillectomies are outpatient procedures where the patient will go home the same day. Adenoidectomy is also performed under general anesthesia and involves a curette to scrape out the adenoid pad. The base is then cauterized. Aspirin products (Motrin, Advil, Ibuprofen) should be stopped 2 weeks prior to surgery to avoid bleeding.

What recovery should I expect after tonsillectomy?

Recovery varies from adults to children. Children usually recover within 1 week whereas adults can take up to 2 weeks. Adults will miss at least 1 week of work. Pain is the most common complaint and this usually peaks by 4-5 days. Pain medication will take the edge off the pain but usually does not completely take it away. Other post-operative symptoms may include bad breath, poor appetite, nausea/vomiting and fatigue. White patches will be seen where the tonsils are removed. These represent the scab and are normal after surgery. Adenoidectomy tends to have much less pain after surgery.

What do I do about the pain?

Some patients are sensitive to the narcotic pain medication (such as Lortab) and may feel nauseated due to this. If vomiting occurs, the Lortab should be stopped and no food given until the patient's stomach feels better. Then ice chips followed by clear liquid should be introduced. If the patient continues to feel nauseated with the pain medication Tylenol liquid should be used. In general aspirin products (Motrin, Advil, Ibuprofen) should not be used as they may lead to excessive bleeding after surgery.

What can I eat after tonsillectomy?

Usually for the first few days liquids such as Popsicles, jello, ice cream and milkshakes should be given. The goal is to keep hydrated. If the patient fells more hungry after this time, soft food should be introduced such as mashed potatoes, macaroni and cheese, and spaghetti. Avoid acidic beverages such as orange juice and lemonade. Also avoid hard foods such as peanuts, potato chips, and apples. If the patient wants something more substantial in the first few days, like a hamburger, he/she can have it.

What should I worry about after tonsillectomy?

The major complication associated with tonsillectomy is bleeding. After surgery, any new blood is abnormal and should be brought to the attention of the physician. If the bleeding is severe, the patient should be brought immediately to the emergency room. Bleeding can occur from 1-5% of the time, this means 1 to 5 people out of a hundred may have bleeding after surgery. In most cases these can be handled in the emergency room. Bleeding can also occur with adenoidectomy but tends to occur more rarely. Also patients may have a fever after tonsillectomy. If this is above 101 the physician should be notified.

When can I go back to my routine activity?

This varies from person to person. Kids need to have little pain and be off of pain medication prior to going back to school. They also need to be eating well. Adults take up to 2 weeks and should be off of narcotic pain medication. In general heavy exercise should be avoided for 2 weeks. Any patient who has tonsillectomy should not leave the area for 2 weeks and should never fly on an airplane during this time.