Tonsillectomy & Adenoidectomy (T&A)

What Are Tonsils and Adenoids?

The tonsils are two pads of tissue located at the back of the throat.
 The adenoids are located higher up behind the nose and cannot be seen through the mouth.

Both are part of the immune system and help fight infection, especially in early childhood. They may be removed if they become enlarged or contribute to repeated infections.

Why Is Surgery Needed?

Tonsillectomy and adenoidectomy may be recommended for:

• Frequent throat infections (tonsillitis)
• Enlarged tonsils or adenoids causing breathing problems
• Snoring or sleep apnea
• Difficulty swallowing
• Chronic nasal congestion (from enlarged adenoids)

These conditions can affect sleep, breathing, and overall quality of life.

Who Needs This Surgery?

Children

Most common reasons include:

• Enlarged tonsils/adenoids causing snoring or sleep apnea
• Recurrent infections

Adults

More commonly recommended for:

• Recurrent or severe tonsillitis
• Sleep apnea or airway obstruction
• Chronic tonsil stones or discomfort

How Is the Procedure Performed?

• The surgery is performed under general anesthesia (patient is fully asleep)
• Tonsils are removed through the mouth
• Adenoids (if removed) are taken out from behind the nose
• No external incisions or scars
• The procedure typically takes 30–45 minutes

What to Expect After Surgery

Children

• Usually go home the same day
• Sore throat for 7–10 days
• May have low-grade fever, bad breath, or ear pain (referred pain)
• May feel tired, restless, or have decreased appetite for several days

Adults

• May go home the same day or occasionally stay overnight
• Sore throat can last 14-21 days or longer
• Pain is typically more significant than in children
• Time off work is usually 2-3 weeks

Recovery Guidelines

Diet and Hydration

• Hydration is the most important factor for recovery
• Encourage frequent small amounts of liquids, especially in the first 2–3 days
• Soft foods are recommended (yogurt, smoothies, soups, Jell-O, custard, Popsicles)
• Diet can advance as tolerated; avoid sharp foods like chips or popcorn
• Favorite foods are acceptable as tolerated

Pain Management

• Throat pain and ear pain are common
• Ear pain often peaks between days 3–7 due to referred pain
• Use prescribed pain medication as directed
• Over-the-counter medications (acetaminophen or ibuprofen) may be used as instructed
• Cool compresses, ice chips, or chewing gum may provide relief
• Do not wake a sleeping child to give pain medication

Fever

• Mild fever (99–102°F) is common in the first few days
• Often related to dehydration
• Treat with ibuprofen as directed
• Avoid duplicate acetaminophen if included in prescription medications

Activity

• Rest at home for the first 48 hours
• Gradually increase activity as tolerated
• Return to school typically in 7–10 days
• Avoid strenuous activity and contact sports for 2 weeks

Common Postoperative Symptoms

• Bad breath: Caused by healing tissue; improves in 5–10 days
• Ear pain: Common and expected; treated like throat pain
• Nausea/Vomiting: May occur within the first 24 hours; usually resolves

Managing Nausea and Vomiting

• Give small sips of liquids every 15–20 minutes initially
• Gradually increase intake as tolerated
• If vomiting occurs after 24 hours, consider medication side effects or illness
• Persistent vomiting with dehydration may require medical evaluation

Bleeding – IMPORTANT!

• Small amounts of blood-tinged saliva may occur
• Risk of bleeding is highest between days 5–10 when scabs separate
• Can also present with vomiting of dark red blood

If bleeding occurs:

• Try cold water or ice water gargling/drinking and may have to repeat this multiple times
• If bleeding lasts longer than 15–20 minutes, go to the emergency room

Benefits of Surgery

Many patients experience:

• Fewer throat infections
• Improved breathing and sleep
• Reduced snoring
• Better overall quality of life

Risks

Tonsillectomy and adenoidectomy are very common and generally safe. Possible risks include:

• Bleeding (most important risk)
• Dehydration
• Infection (rare)
• Temporary voice changes

When to Contact Your Doctor

• Fever over 102°F that does not improve with medication
• Signs of dehydration (low urine output, lethargy, dry mouth)
• Vomiting lasting more than 24 hours
• Fever lasting more than 3 days

Emergency Care

Go to the emergency room if:

• Bleeding does not stop after 15–20 minutes
• Bleeding stops but recurs multiple times within 24 hours

Recommended ER locations:

• Patients 16 and older: Centennial Medical Center Frisco
• Patients under 16: Children’s Medical Center Plano

Follow-Up

Routine follow-up is not required unless requested or concerns arise.