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Ear, Nose and Throat (ENT), Head and Neck Surgery
TONSILLECTOMY refers to the surgical removal of the tonsils.
ADENOIDECTOMY refers to the surgical removal of the adenoids.
Both the surgeries can be done concurrently (called ADENOTONSILLECTOMY) or independently.
6 hours of fasting (i.e strictly NO food or drinks) before the surgery is needed.
The surgery will be done under general anaesthesia (GA) (i.e patient is fully ‘asleep’ and unaware).
What will I experience or expect following the procedure?
After
your
surgery,
your
anaesthetist
and
the
nurses
continue
to
monitor
your
condition
carefully
as
you
gently
return
to
full
consciousness.
You
may
be
given
some
oxygen
through
the
oxygen
mask
to
breathe. Intravenous drips will be given to replenish the fluids that you might require.
1.
You
are
likely
to
feel
drowsy,
tired
and
sleepy
at
this
stage.
Some
may
feel
that
the
throat
is
sore
-
this
is
most
likely
due
to
the
insertion
of
the
breathing
tube
during
surgery.
During
this
time
it
is
important
that
you
relax
as
much
as
you
can,
breathe
deeply,
do
not
be
afraid
to
cough,
and
do
not
hesitate
to
ask
the
nursing
staff
for
any
pain
relief,
and
about
any
queries
you
may
have.
You
are
likely to have hazy memories of this time and some patients experience vivid dreams.
2.
Due
to
the
effects
of
the
general
anesthesia
and
the
drugs
used
during
the
surgery,
you
may
feel
nauseated
and
may
vomit
following
the
procedure.
This
is
normal
and
will
resolve
shortly.
Do
not
be alarmed if there is blood stain in your vomitus or sputum.
3.
After
the
operation,
as
soon
as
you
are
alert
and
conscious
(this
usually
takes
2-4
hours
after
coming
out
from
the
operating
room),
you
are
allowed
to
eat
and
drink.
However,
you
experience
some discomfort due to the pain in the throat.
4.
Diet: It is very important to be watchful of your diet in the first few days following the surgery.
You are encouraged to drink clear cold fluids such as water and take cold food such as ice-cream
or jelly.
Avoid: hot steaming food/drinks as this can increase the risk of bleeding after the surgery.
Favour: cold food/drinks as this lessens the risk of bleeding after the surgery and more soothing on
the healing throat.
Avoid: citrus juices and carbonated beverages (colas) because they may cause increased pain and
throat irritation. Juices that are sour can irritate the raw area where the tonsils used to be,
After a few days start trying foods that are easy to swallow.
Favour: Soft noodles, porridge(cold), jelly/puddings, yogurt, and ice cream.
Avoid: steamy, hot, or spicy foods or hard, crunchy foods.
Your appetite is expected to return to normal soon after.
5.
Drink plenty of fluids. This will prevent you from dehydration.
6.
It is expected that you will still experience some sore throat or blood-tinged saliva (but NOT active
fresh bleeding). Your uvula may
swell up for 3 or 4 days after surgery. You may feel there there is something constantly in the back
of your throat that needs to be swallowed. Don't be alarmed - this is normal ! It will resolve over the
next few days.
7.
If
pain
is
persistent,
please
take
your
pain
medication
(eg.
paracetamol
‘Panadol’,
diclofenac
‘Voltaren’,
celecoxib
‘Celebrex’,
etoricoxib
‘Arcoxia’)
as
prescribed
by
your
surgeon.
You
can
rinse/gargle
gently
with
the
gargle
medication
(eg.
Difflam,
chlorhexidine,
hydrogen
peroxide)
to
cleanse
the
back
of
the
throat
after
eating
and
to help remove any bad taste. Once the pain has resolved, you can stop the painkillers at any time.
8.
Avoid products that contain aspirin because they interfere with blood clotting. This can cause bleeding from the operated site.
9.
You
may
notice
that
voice
has
changed
slightly.
This
is
due
to
the
larger
airspace
in
you
throat
now.
This
is
not
a
cause
for
concern.
On
a
positive
note,
you
should
be
able
to
breathe better now.
10.
You
may
experience
pain
in
one
or
both
your
ears.
This
is
common
during
the
first
week.
This
is
due
to
'referred
pain’.
Referred
pain
is
where
injury
in
one
area
causes
pain
in
another
due
to
the
similar
nerve
supply.
This
does
not
mean
you
have
problems
with
your
ears.
If
it
is
persistent
despite
the
painkillers,
you
are
encouraged
to
return for a review.
11.
You may also have a low-grade fever (less than 37.5 Celcius) for a few days. Please
monitor your temperature.
12.
It is normal to see yellowish/whitish slough at the back of the throat where the tonsils were (see picture). This is due to normal process of
healing over the operated site. This does not necessarily mean there is an infection.
13.
Bad breath may result from scabs where the tonsils were removed. Do not worry as these scabs are expected to fall off in about a week’s
time, after which your breath odor will return to normal. Do not gargle, as this will hurt and may cause bleeding. Rinse your mouth with any
antiseptic mouthwash.
When can I leave hospital ?
Once you have started taking orally and your general condition permitting, you can usually go home the morning after the surgery.
It is important to eat and drink normally even though it may be sore.
You will be given details of when your next appointment in the ENT clinic where your progress will be reviewed.
You
may
return
to
work
in
about
1-2
weeks.
Depending
on
how
soon
your
resume
your
normal
diet
and
the
level
of
pain/discomfort,
most
adults
need about 1 week to recuperate. Children may take longer. You will be given medical leave chit for this period.
You
are
encouraged
to
stay
away
from
smoky
atmospheres
and
people
with
colds,
coughs
or
any
other
infection.
A
throat
infection
during
this
period can lead to bleeding and should this happen you will need to go straight to the nearest accident and emergency department.
When should I call the doctor?
•
Bleeding
•
Persistent pain
•
Not able to resume eating/drinking
•
High fever
The
most
common
significant
risk
is
bleeding
(2-4%
of
cases).
While
blood-stained
saliva
is
expected,
profuse
fresh
bleeding
warrants
medical
attention
!
If
you
have
more
than
2
teaspoons
of
bright
red
blood,
please
return
to
the
ENT
clinic
or
the
nearest
accident
and
emergency
department for a prompt review.
Depending
on
the
amount
of
bleeding,
you
may
need
to
be
returned
to
operating
theatre
to
have
the
bleeding
point
stopped.
Bleeding
also
may
happen between 5 to 10 days after the operation and is nearly always due to infection.
If
you
still
experience
great
pain
despite
the
oral
painkillers,
to
the
extent
of
affecting
your
oral
intake,
re-admission
into
the
ward
may
be
necessary for stronger injection-based systemic painkiller.
If you have a persistent fever (38°C or 100°F) for more than 48 hours and or you develop chills, it may be a sign of infection. Infection increases
the risk of bleeding from the operated site.
With that, we wish you A SPEEDY RECOVERY In your surgery !
Adenoid & Tonsil Surgical Care (English language)
(PDF files will open in a new window)
This patient education is provided in good faith to help patients and their families learn more about their medical conditions, the options available to them and the
possible consequences of their decisions. This information is not intended to be used for diagnosis, or treatment of any specific individual. Please consult with
your ENT doctor regarding your particular circumstances.
Adenoid & Tonsil Surgical Care (Bahasa Malaysia)
Copyright Vincent Specialist Solutions Sdn Bhd 2016. All rights reserved
Last update: 10/1/13
Adenoid & Tonsil Surgical Care (Chinese language)
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