Adult Tonsillectomy

The tonsils are 2 small masses of tissue at the back of the throat. They are part of the body’s immune system. This system helps the body fight disease. Usually, tonsils shrink with age. But in some people, this does not happen and their tonsils become infected or enlarged. This can cause severe sore throats, snoring, sleep disorders, and other problems. Tonsillectomy is surgery to take out the tonsils. Tonsillectomy may be advised if you have obstruction causing sleep apnea. Sleep apnea can happen if something blocks the upper airway during sleep. Sleep apnea can cause fatigue, restlessness, and even high blood pressure. Or you may need surgery if you have recurring, chronic, or severe infections. 

Preparing for surgery

Prepare as you have been told. Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines like NSAIDs, blood thinners, herbs, and other supplements. You may need to stop taking some or all of them before surgery as directed by your healthcare provider. Also follow any directions you’re given for not eating or drinking before surgery.

Be sure to inform your healthcare provider about any of these health conditions:

• if you suffer from bleeding or clotting disorders,

• if you have diabetes, high blood pressure, and sleep disorders

• if you are allergic to anything including certain antibiotics and anesthetic agents.

The day of surgery

The surgery takes about 60 minutes. You will likely go home on the same day.

Before the surgery

Here is what to expect before the surgery starts:

• An IV (intravenous) line is put into a vein in your arm or hand. This line supplies fluids and medicines.

• To keep you free of pain during the surgery, you’re given general anesthesia. This medicine puts you into a deep sleep through the surgery.

During the surgery

Here is what to expect during the surgery:

• A tube will be placed in your throat to keep your airway open.

• A special device is used to keep the mouth open.

• Other tools are used to take out the tonsils or part of the tonsils from the back of the throat. The tissue is taken out through the mouth.

• The device holding the mouth open and the tube are then removed.

After the surgery

You will be taken to the PACU (postanesthesia care unit). There you will be closely kept track og. Healthcare staff will make sure you can drink some liquids. They will also make sure your pain is being managed. When you are ready to leave, you will need to be driven home by an adult family member or friend.

Recovering at home

It will likely take about 2 weeks to heal from the surgery. During your recovery:

• Expect to have throat pain. You may also feel pain in your ears. It occurs because the nerve that supplies the tonsils also supplies a part of the ear. This is “referred” pain from the throat. It is normal. Your pain after surgery may come and go. It may be worse on the first or second day after surgery.

• If your healthcare provider has prescribed you antibiotics, take them as directed and finish all of them.

• Talk as little as possible, if it hurts.

• Take pain medicine as directed. Use liquid pain medicine for pain during the first week, if possible.

• If you have been diagnosed with sleep apnea, talk with your healthcare provider before taking opioids or medicine with codeine.

• Swallowing will be difficult due to pain and muscle spasms in the throat. For the first 3 days, drink plenty of cool liquids to keep the area moist. This will also ease pain.

• Don't drive while you are taking opioid or prescription pain medicine. Expect to feel sleepy or dizzy while you are taking this medicine.

• Don't use ibuprofen or aspirin for 14 days after surgery unless your healthcare provider says it’s OK. You may use acetaminophen as directed.

• Mouth breathing and snoring is expected during the recovery period. due to swelling. Raising the head of your bed as directed by your healthcare provider might help.

• Drink plenty of cool liquids as you can. Water, noncitrus juices, and frozen juice bars are good choices.

• Eat cold foods and soft foods, because these are easier to swallow. Try foods, such as ice cream, gelatin, scrambled eggs, pasta, and mashed potatoes.

• Don't eat foods that need a lot of chewing. Also don't have foods that may scratch the throat, such as toast or potato chips. Don't have hot, spicy, or acidic foods.

• Oral hygiene: You may develop bad breath due to the healing in the back of the throat. Ask your healthcare provider about the mouthwashes that you may use to cleanse your mouth and gargle your throat. Stay away from mouthwashes that cause dryness in your throat.

• You may also become constipated during this time due to lack of a regular solid diet, pain medicines, and limiting your activities. Talk to your healthcare provider about this issue.

• Don't do strenuous activity or heavy lifting for 2 weeks after surgery, or as directed by your healthcare provider.

• Be aware that white patches will form in your throat during healing. These are scabs and are not a sign of infection. The patches will come off in  6 to 9 days and may cause a small amount of bleeding. To reduce bleeding, drink plenty of fluids. Gargling with cold water can help.

• If you are diabetic, extra care and precautions would be necessary as you are more prone to postoperative infection, and delayed, or impaired wound healing. Talk to your nutritionist about a safe diet plan during your recovery as you will be mostly on a liquid-based diet.

Follow-up

Schedule a follow-up visit with your healthcare provider, or as advised. During this visit, the healthcare provider will make sure you are healing well. Ask any questions you have about the surgery or your recovery.

Risks and possible complications

• Infection

• Bleeding

• Lung problems

• Persistent nausea and vomiting

• Injury to the lips, teeth, or jaw

• Severe pain

• Voice changes

• The need for a second surgery

• Risks of anesthesia 

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Fever of 100.4° F ( 38° C) or higher, or as directed by your healthcare provider

• Bright red bleeding from the mouth or nose

• Severe pain not eased by medicine

• Signs of dehydration (dark urine, urinating less often)

• Persistent bleeding in the throat

• Other signs or symptoms as directed by your healthcare provider

Call 911

Call 911 right away if you have either of these:

• Chest pain

• Trouble breathing

• Heavy bleeding from the nose or mouth