Tonsillectomy Children s Ward Patient information Leaflet Page 1
Tonsillectomy Your child is coming into hospital to have a tonsillectomy. The tonsils are removed through your child s mouth. The operation will be carried out under general anaesthetic. Why does my child need a tonsillectomy? The tonsils are lymphoid tissue, which provides a barrier against infection. They are situated at the back of the throat. Your ear, nose and throat doctor may recommend a tonsillectomy for several reasons: The most common reason is to prevent repeated attacks of tonsillitis (inflammation of the tonsils caused by many different individual viruses and bacteria. Tonsillectomy may be advised after an attack of quinsy (a tonsil abscess). Occasionally, tonsillectomy may be advised because the tonsils are too large and causing difficulty with breathing at night. What is the alternative to a tonsillectomy? Antibiotic (medicines that kill bacteria) may be used to treat infection of the tonsils. Antibiotics have been found to be ineffective in the long term. Surgery is the standard treatment that is usually advised. What are the benefits of my child having a tonsillectomy? After the operation your child should not have any bouts of tonsillitis. This does not mean your child will never have a sore throat again. Removal of enlarged tonsils may improve night time breathing Reduce school absence Are there any risks? Very rarely bleeding from the throat may occur after tonsillectomy. If this happens on the day of surgery, another operation may be needed to stop it. Bleeding from the throat at home, during the two weeks following your child s tonsillectomy is usually due to a throat infection. Readmission to hospital for treatment will be needed and possibly another operation if the bleeding does not stop. Capped, crowned or loose teeth are fragile and may be damaged or dislodged during the operation if the surgeon is not aware of their presence. (Please make sure that you informed either the nurses or doctors prior to your child s operation. What happens during my child s stay on the ward? Your child will be admitted to the ward either in the morning or the afternoon; the nursing team will make an assessment, apply two wrist bands and a local anaesthetic cream to your child s hands if over 1 year and not medically Page 2
exempt. They will be seen by a doctor if you have not signed the consent form in clinic. Your child will be assessed by the anaesthetist prior to surgery to ensure he is medically fit for theatre. Your child will be on a theatre list but we can only give an approximate guide to when your child will go to theatre. Before the operation your child will be seen by the nursing team, if you have any concerns then please do not hesitate to mention them. One parent will be able to stay in the anaesthetic room until your child is asleep. On waking you child will be brought back to you on the ward when the recovery team are happy. During the recovery period on the ward your child will be assessed by the nursing team and offered fluids then diet, when safe to do so. Your child may have a cannula in on return to the ward. We recommend that this is kept in until prior to your child going home as if your child has a bleed or is vomiting I.V. access is available. When can my child go home? Your child may need to stay in hospital for at least 6 to 8 hours or one night depending on the consultant s advice. One parent is welcome to stay overnight with your child. Prior to discharge your child will need to have: Eaten an adequate amount of diet and fluids Had no bleeding Passed urine No vomiting A normal temperature Doctors deem fit for discharge We recommend that your child does not travel home on public transport due to the risk of infection. How do I care for my child after their tonsillectomy? The major risk following a tonsillectomy is a post tonsillectomy bleed. Although this cannot always be prevented, you can help reduce the risk by following this advice: School - Your child will need to stay off school for at least two weeks to feel completely well. Eating and drinking we recommend your child eats a normal diet. Encouragement to eat rough foods will help to clean the tonsil beds, helping to reduce the risk of infection and the risk of bleeding. Chewing gum and sweets can help reduce your child s pain by preventing muscle spasms. Please avoid people with coughs and colds and Smokey atmospheres for the first two weeks. Your child getting an infection will increase their risk of a bleed. Page 3
Will my child be in pain? Your child will be given pain relief in theatre to aid their comfort on return to the ward. We will also administer, when possible, regular pain relief when back on the ward. Some children have a sore throat for two weeks and it is common to get earache after a tonsillectomy. Your child will be discharged from the ward with pain relief from the hospital pharmacy. We recommend that you follow the instructions on the bottle, giving pain relief regularly especially prior to meals. If you are given two medicines for pain relief, alternate when they are given to cover the maximum amount of time your child will be comfortable. Keeping your child pain free will help encourage eating and drinking and therefore reduce the risk of bleeding. Please note that there is sometimes a delay in the hospital pharmacy dispensing medications to take home. Please note that if your child is fit for discharge you may be asked to return later to collect the medications if appropriate. What do I do if my child becomes unwell? During the time your child s throat is healing, you may notice bruising in the throat, and white patches at the sides of the throat. This is normal and not a cause for concern. If your child develops: A temperature Smelly breath Vomiting or is generally unwell please contact either your g.p. or the ward for advice. If your child s has any BLEEDING, from their mouth or nose, however small, take your child to your nearest Emergency Department immediately. Follow up Your child may be given an outpatient appointment if required. Normally approximately 2-3 months after surgery. Where applicable, your child s consultant may ask for a repeat sleep study, to assess for improvement after your child s tonsillectomy. Further information If you have any questions or are unsure about any of the information provided in this booklet, please contact the Children s ward on 01384 244271. Page 4
This Information can be made available in large print, audio version and in other languages, please call 0800 0730510. Originator: Clare Evans Date: March 2013 Version: 1 Date for Review: March 2016 DGOH Ref: DGOH/PIL/00826 Page 5