What is a tonsillectomy and adenoidectomy?

You may have been referred to an ear, nose, and throat surgeon (ENT) to have the tonsils and adenoids removed. This surgery is called a tonsillectomy and adenoidectomy. Often the tonsils and adenoids are removed at the same time. But sometimes only one or the other is removed. Your ENT will discuss this with you.

The tonsils are tissue located on either side of the back of the throat. The adenoids are located behind the nose and at the top (roof) of the mouth. Both the tonsils and adenoids are part of the immune system, the part of the body that fights infection and disease.

Why might I need a tonsillectomy and adenoidectomy?

Healthcare providers are not in complete agreement about when someone should have a tonsillectomy or adenoidectomy. But here are some guidelines that are followed.

Tonsillectomy

A tonsillectomy may be recommended if you have throat infections that keep coming back. A throat infection means you have a sore throat with fever. Or if you have swollen neck glands or drainage from the tonsils. Or have a positive strep test. Or have the following:

• 7 or more throat infections in 1 year

• 5 or more throat infections in each of 2 years

• 3 or more throat infections in each of 3 years

A tonsillectomy may also be recommended if you have recurrent throat infections and any of these:

• Unable to take antibiotic medicine or has antibiotic medicine allergies

• Have episodes of fever, sores in the mouth, sore throat, and swollen neck glands

• Have had an infected area near the tonsils

A tonsillectomy may also be recommended if:

• Abnormal breathing while sleeping with enlarged tonsils. This might be brief episodes where breathing stops.

• Very large tonsils that block breathing through the nose or cause difficulty swallowing

Adenoidectomy

Adenoidectomy is recommended if you have a lot of trouble breathing through the nose. It may also be recommended if you have:

• A long-term (chronic) sinus infection

• Middle ear infections that keep coming back

• A chronic middle ear infection with fluid and already has ear tubes

What are the risks of a tonsillectomy and adenoidectomy?

All surgeries have risks including bleeding, infection, and complications from general anesthesia. The risks of tonsillectomy and adenoidectomy are:

• Long-term throat pain

• Excessive bleeding from the tonsils

• Damage to teeth, voice box, throat, or roof of the mouth, or other nearby tissue

• Breathing problems

After surgery, you may have nausea, vomiting, pain, dehydration, ear pain, or throat or lung problems.

How do I get ready for a tonsillectomy and adenoidectomy?

Your ENT provider may want to do some tests before surgery. If you have problems while sleeping, a sleep study may be done.

The ENT will explain the surgery and answer any questions. Make sure you talk with your ENT about:

• Any medicines that you should not take before surgery. This includes over-the-counter medicines.

• When you need to stop eating and drinking. For example, it is common not to eat or drink after midnight the night before surgery.

• When you need to arrive at the hospital or facility

• What to expect  your child after surgery

• When you can get back to normal activities

And if you get sick before surgery, call your ENT. Surgery may need to be rescheduled.

What happens during a tonsillectomy and adenoidectomy?

Most likely your tonsillectomy, or adenoidectomy will be performed as a outpatient surgey. That means that you will go home the same day as the surgery. The surgery usually takes between 30 and 45 minutes. You will get medicine to sleep during the surgery (general anesthesia). Some patients may need to stay overnight. This may include people who:

• Are not drinking well after surgery

• Have other health problems

• Have complications after surgery, such as bleeding

• Are younger than age 3

• Have sleep apnea diagnosed by a sleep study

In general, the surgery will go as follows:

Your  will be given general anesthesia.

• You will be given general anesthesia.

• Medicines and fluids will be given by IV.

• The ENT will remove your tonsils and adenoids through the mouth. There will be no cut on the skin.

What happens after a tonsillectomy and adenoidectomy?

• After the surgery, you will go to a recovery room where he or she can be watched closely. 

• You will receive medicine for pain.

• After you are fully awake, a nurse will bring you back to the day surgery area.

Your throat will be very painful for the first 2 days. Pain may last up to 2 weeks.

Instructions for care at home may include:

• Making sure you are drinking well. This helps to prevent dehydration and helps to lessen pain. Stay away from milk, orange, and other citrus juices.

• Giving pain medicine. Your ENT will give you a regimine. Call you ENT if you are unable to control your pain.

• Eating soft, warm foods. Avoid hard and spicy foods.

• Be active while at home. You should stay away from vigorous activities. Your ENT will tell you when you can go back to all normal activities.

• Staying away from others with colds or other respiratory infections.

Make sure to attend follow-up appointments with the ENT. And call the ENT if you are not getting better, or if you have any questions or concerns.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure

• The reason your having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• When and where your having the test or procedure

• Who will do the procedure and what that person’s qualifications are

• What would happen if you do not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or problems

• How much will you have to pay for the test or procedure