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Adenotonsillectomy

Welcome to our patient information page about Adenotonsillectomy surgery. You can learn more about what to expect when you are scheduled for an adenotonsillectomy. Find pre- and post-operative instructions here.

Have any questions about your upcoming adenotonsillectomy procedure with Dr. Karamy?

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Patient Information for Adenotonsillectomy

What is Adenotonsillectomy?

Adenotonsillectomy is a surgical procedure that involves the removal of both the adenoids and tonsils. The adenoids are lymphoid tissues located at the back of the nasal cavity, while the tonsils are located on each side of the throat. This procedure is commonly performed in children but can also be recommended for adults with specific indications.

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Indications for Adenotonsillectomy:

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Adenotonsillectomy may be recommended for the following conditions:

  1. Recurrent Tonsillitis: If a child experiences frequent or severe tonsillitis infections that significantly impact their quality of life, removal of the tonsils may be considered.

  2. Obstructive Sleep Apnea (OSA): Enlarged tonsils and adenoids can contribute to obstructive sleep apnea, a condition where breathing is disrupted during sleep. Adenotonsillectomy can be effective in improving breathing and sleep patterns in such cases.

  3. Chronic or Recurrent Ear Infections: Enlarged adenoids can contribute to ear infections in children, and removal may be recommended when other treatments are ineffective.

  4. Nasal Breathing Difficulty: When enlarged adenoids cause difficulty breathing, especially during the day, isolated adenoidectomy may be considered often in conjunction with turbinate reduction.

What Happens During Adenotonsillectomy Surgery?

Adenotonsillectomy is usually performed under general anesthesia, which means the patient will be asleep and unaware during the procedure. The surgeon will remove the adenoids through the mouth, and the tonsils are usually removed using a surgical instrument that cuts and seals the blood vessels.

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The procedure typically takes about 30 to 45 minutes to complete. Afterward, the patient will be taken to a recovery area to wake up from anesthesia.

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Pre-Operative Instructions for Adenotonsillectomy

Before the adenotonsillectomy, you or your child may receive specific instructions from your healthcare provider, including:

  • Fasting: Typically, you or your child will need to avoid eating or drinking for a specified period before the surgery to reduce the risk of aspiration during anesthesia. In general, no food after midnight the night before and can have clear fluids up to 3 hours prior to the surgery start. Clear fluid includes anything you can see through and that does not have texture like pulp. To be safe stick to water, apple juice, Gatorade, or ginger ale.

  • Medications: Stock up on acetaminophen (Tylenol) and ibuprofen (Advil)

  • Recent sickness: Unfortunately children who require this surgery tend to be of the age where they get sick frequently. Illness around the time of surgery is common. It will generally be up to the discretion of the anesthesia whether the surgery commences based on various factors. 

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Post-Operative Care & Instructions

After the surgery, you or your child will need to follow specific post-operative care instructions:

  • Recovery Period: Plan for at least one to two weeks of recovery, during which you or your child may experience throat pain, ear pain, and difficulty swallowing.

  • Pain Management: For young children we generally recommend giving the maximum dose of acetaminophen (Tylenol) and ibuprofen (Advil) for your child's weight. Older children may be prescribed additional opioid medication to combine as well. Acetaminophen is 15 mg/kg up to 5 times per day and ibuprofen is 10 mg/kg up to 4 times per day.

  • Dietary Guidelines: Initially, consume soft foods and cool liquids to ease swallowing. Avoid spicy, hard, acidic, or hot foods that can irritate the throat. We recommend the child to eat what makes them comfortable and not to limit their diet purposefully otherwise.

  • Hydration: Stay well-hydrated with frequent sips of water. Stock up the fridge/freezer with treats like popsicles, ice cream, Jello, and smoothies. 

  • Rest: While adequate rest is crucial during the recovery period to support healing, if a child feels well, it will be difficult to contain them, and nor should you.

  • Activity Restrictions: Avoid strenuous physical activities and contact sports during the recovery period. 

  • Follow-Up: Most children do fairly well after 10 to 14 days post-operatively with a dramatic improvement in symptoms. They do not need to have routine follow up if they are that much better. However if some of their issues continue or they had complications they should arrange a follow up 2 to 3 weeks post-operatively.

 

Potential Complications and When to Seek Medical Attention:

While adenotonsillectomy is generally safe, complications can occur. You will need to go the emergency department (ED) if:

  • Excessive bleeding: Any bleeding, unless a single occurence and small, should go to be evaluated. Small bleeds can sometimes become larger as well.

  • Dehydration: If your child is not drinking, and not urinating much, they need to go to the ED for possibly intravenous fluids.

  • Severe pain: Sometimes falling behind on pain medication makes it challenging to catch up. If your child is now refusing pain medication due to pain, its time to get an intravenous dose in the ED.

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If you are experiencing concerning symptoms or have any questions after an adenotonsillectomy procedure with Dr. Karamy, please call the office and leave a voicemail. For emergencies, please go to the emergency department.

Disclaimer

The information provided on this webpage is for educational purposes only and should not replace medical advice. Please consult with a healthcare professional for a proper diagnosis and individualized treatment recommendations.

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