Your child needs an operation to take out their tonsils. Your child may also need an operation to take out their adenoids at the same time. These operations are called tonsillectomy and adenoidectomy.
What are tonsils?
The tonsils are small pieces of tissue at the back of the mouth, beside the tongue. They help fight germs. There is one tonsil on either side of the throat.
What are adenoids?
Adenoids are lumps of tissue up behind the nose. You cannot see your child's adenoids when looking in the mouth.
Removing enlarged tonsils and adenoids
After many infections, the tonsils and adenoids often become enlarged. This can interfere with breathing. Enlarged adenoids can also affect the tubes that connect the middle ears and the back of the nose. When tonsils or adenoids become too large, they may need to be taken out.
Removing the tonsils and adenoids improves breathing. It may also help your child have fewer ear and throat infections.
An otolaryngologist/head and neck surgeon will do the operation. An otolaryngologist is a doctor who specializes in problems of the ears, nose and throat.
Before the operation
Several hours before the surgery, your child will need to stop eating and drinking. The doctor or nurse will tell you exactly when this must happen.
Write this information down here:
- The date and time of the operation:
- When your child must stop eating:
- When your child must stop drinking clear fluids:
- Other things to remember:
Surgery to remove the tonsils and adenoids
The doctor will give your child a special sleep medicine called a general anaesthetic. This will make sure your child sleeps through the operation and does not feel any pain.
While your child is asleep, the doctor will remove the tonsils through your child's mouth. If your child is also having an adenoidectomy, the doctor will take out your child's adenoids at the same time. Your child will not get stitches.
The operation usually takes from 45 to 60 minutes.
You will be able to see your child as soon as they are fully awake
A volunteer from the Surgical Waiting Room will bring you to see your child.
After the operation
After the operation, we will take your child to the recovery room, also called the Post Anaesthetic Care Unit (PACU). This is where your child will wake up. Your child will stay in the PACU for about one hour. We will then move your child to a room on the nursing unit.
Your child will be closely monitored on the nursing unit
- Your child will be encouraged to take fluids by mouth. Your child will start with sips of clear fluids (liquids you can see through, such as water or apple juice), ice chips or freezies. Once your child can take sips, they can then drink liquids from a cup.
- Your child's temperature and vital signs will be taken regularly.
- Your child will still have an intravenous (IV) tube in their arm. It will remain in place until discharge.
- Your child will be given pain medicine when needed.
- The nursing staff will watch your child for vomiting (throwing up) or bleeding.
- The nurses will tell the doctor if there are any complications.
- When your child is fully awake, they can get up with help to use the washroom.
- Your child may throw up thick, brownish-coloured liquid if they swallowed some blood during or after the operation. This is normal. If your child keeps throwing up, they will receive medicine through the IV to help settle their upset stomach.
Managing your child's pain after the operation
When your child has pain after the operation, they will be given pain medicine either:
- by liquid, to swallow
- if they cannot swallow, by a suppository that goes into your child's rectum.
These are ways nurses can help make your child more comfortable:
- humidified air to keep the throat moist
- raising your child's head and shoulders to help reduce swelling.
Usually just one day in the hospital
Most children are ready to go home from the hospital about six to eight hours after the operation. Sometimes, children need to stay for a longer time.
You should take your child home in a car or a taxi. For your child's comfort and safety, do not take your child home by bus or subway.
Caring for your child at home
Pain
Your child will have some pain after the operation.
Your child will have a sore throat. They may also have an earache, which is caused by the sore throat. Five or six days after the operation, your child's sore throat or earache may get worse for a short time. This is normal.
Your child may also have a stiff neck. If this does not improve, call your doctor.
You may give your child medicine for pain.
You may receive a prescription for pain medication before you leave the hospital. Follow the dosage instructions given to you by the pharmacist. Although these prescription pain medications can be beneficial, they are also potentially very dangerous if not used properly.
When using these medications, if you notice any changes in either breathing or level of drowsiness that concern you, stop the medication and seek medical attention. If your child is unresponsive, call 911 immediately.
Do not give your child over-the-counter medicine that may have a sedative effect (makes people sleepy) while giving the prescription for pain medicine. Examples of these medicines are decongestants and antihistamines. Discuss these medications with your pharmacist.
You may give your child acetaminophen and/or ibuprofen if they have pain. Give the dose printed on the bottle for your child's weight. Do not give your child acetylsalicylic acid (ASA) for two weeks after the surgery. ASA could increase your child's risk of bleeding after the operation. Check with the nurse or doctor first before giving these medicines to your child.
Drinking
It is very important that your child have lots to drink after the operation. Try to get your child to drink at least four glasses of liquid a day over the first few days after the operation. Let your child drink as much liquid or liquidy foods, such as Jell-O and yogurt, as they want.
Do not let your child have orange, lemon or grapefruit juices or other citrus fruits for seven to 10 days. These contain acid, and your child may find them painful to drink.
Eating
When your child can drink liquids without throwing up, they may eat soft foods such as noodles, eggs and yogurt. When your child can eat soft foods comfortably, they may eat regular foods.
Your child should not eat hard foods, such as toast or pizza crust, for two weeks after the operation. These foods may scratch their throat and cause pain and bleeding.
Mouth care
Your child's mouth may smell different for two weeks after the operation. Have your child rinse their mouth with water or gently brush their teeth. Do not let your child gargle or swish anything around in the back of their throat.
Your child may have white patches where the tonsils were for several days. This does not mean that your child has an infection. To protect your child's throat, make sure your child tries not to cough, talk loudly or clear their throat a lot for seven to 10 days. Teach your child to sneeze with their mouth open. Do not let your child blow their nose for at least one week after the operation. They should dab their nose with a tissue if it is dripping.
To help your child breathe more comfortably, you can use a machine called a humidifier. This machine makes the air moist with a cool mist. Put it at your child's bedside.
To reduce swelling and make your child more comfortable, try raising your child's head and shoulders.
If your child also had their adenoids taken out, their voice may sound as if they are talking through their nose. This is normal. This may last for a few weeks or up to three months, if the adenoids were very large.
Activity
Your child should limit their activity for about a week after the operation. Do not let your child play rough sports or contact sports.
Your child can shower or bathe as usual. Your child should stay away from crowds and people with infections and colds.
Your child can go back to school or day care in seven to 10 days after the operation. You should not let your child go on long trips out of town for two weeks after the operation.
Your child may need a follow-up appointment
If your otolaryngologist has asked to see your child again in the clinic, the clinic will make you an appointment for your child.
Reasons to call the doctor
Please call your child's otolaryngologist, the otolaryngology clinic nurse or your family doctor if your child has any of the following signs after going home:
- fever of 38.5°C (101°F) or higher
- vomiting (throwing up) that does not stop
- pain that gets worse
- refusing to drink
- child does not urinate (pee) within 12 hours of the operation
- fresh blood in the nose or mouth.
If your child is bleeding, having trouble breathing, or if you have other concerns, take your child to the closest emergency department right away.
Write down contact information here:
Otolaryngologist's name and number:
Otolaryngology clinic nurse's number:
Family doctor's name and number: