Tonsillectomy In Children
A. What is tonsillectomy?
Tonsillectomy is the surgical removal of the tonsils. The tonsils are two small almond-shaped mounds of lymphatic tissue that sit on either side of the back of the throat.
They are part of your body’s system to fight infection and they are only important during the first few years of life. Tonsils fight infection in the body by filtering bacteria. During this filtering process, the tonsils themselves may become infected. The patient will be admitted for 1- 2 days to undergo tonsillectomy. It is performed under general anaesthesia, which means the patient will be asleep for the entire operation. The operation is performed through the mouth, meaning there will be no external (outside) cuts or scars.
B. Reasons & benefits for tonsillectomy
Removal of the tonsils is usually recommended in cases where one has recurrent episodes of infections of the tonsils, swollen tonsils that cause one to snore and swollen tonsils that make it harder to breathe or swallow.
It is also recommended when one has recurrent
episodes of tonsillitis interfering with normal school or work life. Removal of the tonsils improves the general health and greatly reduces further episodes of tonsillitis.
C. Risks of tonsillectomy
As with all surgical procedures, tonsillectomy is not risk free. Sometimes complications arising from the general anaesthesia may occur. Infection may also occur requiring management with antibiotics. Bleeding from the surgical site may also occur and may require a return to theatre, blood transfusion if bleeding is excessive, or readmission into hospital. Pain or difficulty in swallowing may occur for up to 2 weeks after tonsillectomy requiring management with pain medication. Injury to the teeth, lips, gums of tongue may also occur. There is also a risk of death with any operation but this risk is extremely small for tonsillectomy.
D. Preparation for tonsillectomy
Detailed pre-surgical assessment will be carried out so as to ensure that one is fit for surgery and also to minimize the complications that may occur.
This involves blood tests and general health checks. Blood grouping will also be done so as to have blood on standby for transfusion in case excessive bleeding occurs during the surgery.
E. What happens after tonsillectomy?
One may feel tired due to the general anesthesia. The throat may look white with scabs on it. Pain will occur after one is fully awake.
This will be managed by pain medication. You may go home one day after the surgery. Sucking ice can also help reduce the pain. Ear pain may occur for 2-3 days after the surgery. Complete healing occurs in 10-14 days. It is normal to spit small amounts of blood stained saliva. Normal eating and drinking can be done one day after the surgery. A balanced diet with plenty of fluids is helpful in healing and preventing infection. Follow up appointment may be planned just before leaving hospital.
F. What to look out for at home
Spitting of small amounts of red coloured saliva is normal. Pain may persist for a few days. This can be eased by taking pain relief medication. Taking pain medication 30 minutes before eating also helps prevent pain due to swallowing.
The hospital or the doctor should be contacted in case any of the following occurs:
- A high temperature (38ºC or above),
- Difficulty taking fluids or eating,
- Or the painkillers are not controlling the pain.
One should see a doctor immediately in case there is bright red, black or brown vomit, spitting out bright red blood or large clots; or difficulty breathing.
It is ok to seek advice from the doctor/ hospital for any other problem one may be experiencing.
G. Risks of not undergoing tonsillectomy
Tonsillectomy is mostly recommended as a possible ultimate solution to other illnesses such as recurrent throat infections, persistent snoring, or difficulty in swallowing or breathing. Without tonsillectomy such illnesses will most likely recur thus affecting the quality of one’s health and causing other complications such as rheumatic heart disease.
H. Alternatives to tonsillectomy
In case one chooses not to undergo tonsillectomy, symptomatic treatment of the underlying illness will be done. This mainly involves antibiotics and pain medication.
I. Consent for tonsillectomy
By giving consent you are giving authorization for the patient to undergo tonsillectomy after understanding the need, benefits and risks of the procedure. You are encouraged to ask and have your questions answered before consenting. Although due professional care will be taken, no guarantee has been made regarding the outcomes.
By refusing to consent you signify that although a request for your consent has been made and all explanations given, you have made an informed choice not to have tonsillectomy done.
K. Can I ask a question?
It is ok to ask questions relating to the procedure and its outcomes at any time. You may ask any member of the team taking care of you for any clarification you need. Should they deem it fit, they may consult other team members so that the best possible answers to your questions are availed. You can also request for a second opinion should you feel like having one.