Tonsillectomy and Adenoidectomy
Tonsillectomy is the commonest surgical procedure performed worldwide. It is most commonly done in children, although adults often benefit as well.
The procedure is done under general anaesthesia. No incisions on the face are required, as everything is accessible through the mouth. The method of removal varies between surgeons. The procedure is usually done as a day procedure, meaning the patient can go home on the same day, except in certain cases, such as children with heart problems, who will be admitted for observation, at least overnight.
Children in particular recover very quickly. In adults, the procedure can be rather painful. The most important thing is for the patient to eat and drink as normal. Eating exercises the jaw muscles and prevents spasm, decreasing pain. Some surgeons may advise chewing gum. Although a normal diet is advocated, very acidic foods such as oranges or pineapples should be avoided, at least initially.
It is normal to see a white layer at the back of the throat after the operation. This is how the tonsils heal.
The major complication of an adeno-tonsillectomy is post-operative bleeding. This may occur soon after surgery, or up to ten days later. It is not unusual to see a little blood mixed with saliva, but any frank blood should prompt a visit to the emergency department.
A grommet is a tiny plastic or titanium tube that is inserted into the eardrum via a tiny incision, to drain fluid or to allow for equalisation of pressure, or both. Children with recurrent otitis media benefit because grommets because the number of episodes and severity decrease following insertion.
The surgery is done under general anaesthetic, as a day procedure. No cuts are required, and everything is done through the ear canal.
Grommets are usually short-term solutions, until the child’s Eustachian tube has matured sufficiently. However, this may take several years, and multiple sets may be required over that time. A grommet usually falls out on its own after 12 – 18 months.
There are usually no major sequelae to grommets, but some patients may develop a discharge from the ear. In this case, consult your ENT.
Grommets and adeno-tonsillectomy are occasionally done in a single admission.