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Tonsillectomy in Children

AMBULATORY CARE:

What you need to know about a tonsillectomy:

A tonsillectomy is surgery to remove your child's tonsils. Tonsils are 2 large lumps of tissue in the back of your child's throat. Your child's tonsils may need to be removed if he or she has frequent throat infections or trouble breathing during sleep.

How to prepare your child for a tonsillectomy:

  • Your child's surgeon will tell you how to prepare. He or she may tell you not to let your child eat or drink anything after midnight before surgery.
  • Tell your child's surgeon about all the medicines your child currently takes. He or she will tell you if you need to stop any of your child's medicines for surgery, and when to stop. He or she will tell you which medicines to give your child on the day of surgery.
  • Tell your child's healthcare provider about all of your child's allergies. Tell him or her if your child has had an allergic reaction to anesthesia or any other medicines.

What will happen during your child's tonsillectomy:

Your child will be given general anesthesia to keep him or her asleep and free from pain during surgery. Your child will be also given medicine to help prevent nausea and vomiting. The surgeon will place tools inside your child's mouth to keep it open. He or she will then cut all or part of your child's tonsils away from the surrounding tissue. The surgeon will stop any bleeding from the areas where the tonsils were removed.

What will happen after your child's tonsillectomy:

Your child may need to stay in the hospital if he or she is younger than 3 years. Your child may also need to stay overnight if he or she has breathing or other health problems. Your child will have throat pain that may last up to 2 weeks. His or her throat pain may be worse in the morning. This pain may spread to his or her ears. It may hurt for your child to swallow, and he or she may not feel like eating or drinking. Give your child a lot of liquids to help prevent dehydration. Your child will have white patches in the back of his or her throat. These are scabs that will fall off after about a week.

Risks of a tonsillectomy:

Your child may bleed more than expected or get an infection. He or she may have swelling in the mouth, throat, or lungs that makes it hard to breathe. Your child may have nausea and vomiting after surgery. Your child may have changes in his or her voice or sense of taste after surgery. Tools used to remove your child's tonsils may cause injury to his or her teeth, voice box, or palate. Tools that use heat or a laser to remove his or her tonsils can cause a burn. Your child's tonsils could grow back after surgery.

Call your local emergency number (911 in the US) if:

  • Your child has trouble breathing.

Call your child's doctor or surgeon if:

  • Your child has signs of dehydration, such as dry mouth or eyes. He or she may urinate less than usual or not at all.
  • Your child has severe pain.
  • Your child has a fever above 102°F (39°C), or a low-grade fever for longer than 2 days.
  • Your child has bright red bleeding from the throat, nose, or mouth, or his or her bleeding gets worse.
  • Your child has stomach pain or is vomiting.
  • Your child has new or worsening symptoms.
  • You have questions or concerns about your child's condition or care.

Medicines:

Your child may need any of the following:

  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
  • Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  • Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.

Care for you child at home:

  • Limit your child's activities. Your child will need to rest after surgery. Ask the surgeon when your child can return to his or her daily activities, such as school or sports.
  • Give your child liquids. This will help prevent dehydration. Ask the surgeon how much liquid your child needs. Liquids and foods that are cool or cold, such as water, apple or grape juice, popsicles, and gelatin, will help decrease pain and swelling. Do not give your child citrus juices, such as orange juice or grapefruit juice. Do not give your child hot liquids such as soup or tea. These liquids may hurt his or her throat.
  • Do not give your child straws for up to 2 weeks, or as directed by his or her surgeon. Drinking from a straw may increase your child's risk for bleeding.
  • Give your child soft foods for 10 to 14 days to decrease pain during eating. Examples are applesauce, scrambled or boiled eggs, mashed potatoes, macaroni, and ice cream. Your child may slowly begin to eat solid foods once he or she can eat soft food easily. Do not give him or her anything spicy, hot, or with sharp edges, such as chips.
  • Clean your child's mouth. Gently rinse his or her mouth as directed to remove blood and mucus. The white scabs that will form in the back of the throat will cause bad breath. This is normal. Do not let your child gargle or brush his or her teeth too hard. This can cause bleeding. Help your child gently brush his or her teeth if needed.

Follow up with your child's doctor or surgeon as directed:

Write down your questions so you remember to ask them during your child's visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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