Your specialist has recommended
that your child has his/her tonsils, adenoids, or all of these
removed. This leaflet provides some standard information and advice
about the procedure. However, you should always follow the instructions
of your own specialist.
If you have any unanswered questions or concerns, please do not
hesitate to ask your specialist or nurse for more information.
It is natural to feel anxious, but often knowing what to expect
can help. |
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| What is an adenotonsillectomy?
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The tonsils and adenoids
are made of tissue that fights infection, but they are not essential
for good health.
Removal of the tonsils alone is called a tonsillectomy. Removal
of the adenoids is called an adenoidectomy. Removing them all
is called an adenotonsillectomy.
The procedure is usually carried out as a day case with no overnight
stay. It will be performed under a general anaesthetic. This means
your child will be asleep throughout the procedure. If you would
like more information about general anaesthesia, please see a
separate leaflet. |
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| Preparing for the operation
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Your specialist or hospital
will give you some information about when and how to check into
hospital.
If your child has a cold or tonsillitis in the week before the
operation, please phone to your specialist to let them know. The
operation may have to be postponed to give him time to get better.
Before he comes into hospital, your child should:
- Have a bath or shower on the day of his admission
- Follow the fasting instructions given by your
doctor. Typically, he must not eat or drink for about six
hours before a general anaesthetic. Childrenˇ¦s operations
are usually scheduled for the morning so he will probably
only need to skip breakfast
When you arrive at the hospital, a nurse will explain how your
child will be cared for during his treatment and will perform
some simple tests such as checking his pulse, blood pressure and
temperature. The nurse will also ask you to hand in any tablets,
inhalers or other medicines that your child may be using. The
nursing staff will then give these at the correct times during
his stay in hospital.
Your childˇ¦s surgeon and anaesthetist will also visit. This is
a good time to ask any outstanding questions about his treatment.
If your child has any loose teeth, you should tell the surgeon,
as he will be working inside the mouth. |
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| Consent |
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As the parent or guardian,
you will be given a consent form to sign. By doing this, you confirm
that you understand what the procedure involves, including the
benefits and risks, and give your permission for it to go ahead.
Please see the back of this leaflet for further information about
the possible side-effects and complications of this procedure.
You need to know about these in order to give your informed consent.
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| About the operation |
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You will be encouraged to
stay with your son as far as the anaesthetic room, which is where
he will be put off to sleep.
Adenotonsillectomy is a straightforward procedure, using specially
adapted instruments. Once the procedure has been completed, the
surgeon will take care to stop any bleeding while your child is
still under the anaesthetic.
The operation usually lasts about 30 minutes. |
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| After the operation |
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| Your child will be taken
from the operating theatre to a recovery room on a trolley or
bed, where he will come round from the anaesthetic under close
supervision. If you wish, you can usually be present when he wakes
up. After this, the nurse will take your child back to his room
and make him comfortable. He will feel groggy, and may feel or
be sick. A nurse will monitor his blood pressure and pulse at
regular intervals. |
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| Back on the ward |
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Your child will need to
rest on his side in bed until the effects of the anaesthetic have
passed. To start with, his throat or ears will be sore and his
jaw may feel stiff. He may require painkillers, which can usually
be taken every four to six hours. Please discuss this with your
nurse, surgeon or anaesthetist.
When he feels ready, he can begin to drink and eat, starting with
clear fluids such as water or apple juice. Swallowing will be
sore for a few days. |
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| Going home |
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If your child is eating
well, he should be able to go home on the same day as, or the
day after, the operation.
A nurse will advise you about caring for him at home and give
you a contact telephone number for the hospital, in case you need
to ask for any further advice.
You may be given an appointment for him to come back to the outpatient
clinic for a check-up. |
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| After your child returns
home |
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If your child has a sore
throat or earache, you can give him paracetamol syrup (Calpol)
or ibuprofen syrup (Nurofen syrup). Make sure you follow the instructions
on the bottle. You can usually give up to four doses per day.
Giving him a dose half an hour before mealtimes may help make
eating less uncomfortable.
He will probably need a diet of soft food for up to a week. But
it is important for him to eat and chew solid food as soon as
possible after the operation. This will be difficult start with,
but actually may make the sore throat go away more quickly. Solid
food will help keep throat clean and prevent infection.
Your child should stay at home for7-14 days from the day of the
operation. Where possible, he should avoid contact with other
children and people with colds, coughs or other infections. He
should avoid strenuous activities during this time.
Encourage him to breathe through his nose, and to brush his teeth
as normal.
Contact the hospital if he has any of the following symptoms:
- persistent or increasing bleeding
- inability to drink normally, which can lead to
dehydration
- fever
Complete recovery can take two weeks. |
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| What are the risks? |
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| Adenotonsillectomy is a
routine and generally safe procedure. For most children, the benefits
in terms of improved symptoms are greater than the disadvantages.
However, all surgery does carry some element of risk. This can
be divided into the risk of sideeffects and the risk of complications.
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| Side-effects |
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| These are the unwanted but
mostly temporary effects of a successful treatment. One example
is feeling or being sick as a result of the anaesthetic. After
an adenotonsillectomy, your son will probably have a sore throat,
earache, or both of these, which may last for up to two weeks.
This can make swallowing uncomfortable to begin with. |
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| Complications |
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This is when problems occur
during or after the operation. Most children are not affected.
The main possible complications of any surgery are excessive bleeding
during or very soon after the operation, infection and an unexpected
reaction to the anaesthetic.
Specific complications of adenotonsillectomy are uncommon but
can include bleeding in the first 24 hours after the operation.
The nursing staff will observe your child closely for at least
the first few hours after the operation. He should lie on his
side to allow any bleeding to be detected.
If bleeding occurs, your child may be taken back to the operating
theatre and given another general anaesthetic so that the surgeon
can stop the bleeding.
More rarely, bleeding four to ten days after the operation can
occur, possibly as a result of infection. If this happens, you
should contact us immediately as your child may need readmission
to hospital.
Most children having this type of operation are in good general
health. This makes the chance of complications very low. However,
you should ask your surgeon to explain how the risks apply to
your child. |
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| Further information |
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American College of Surgeons
http://www.facs.org/public_info/operation/tonsiladen.pdf
American Academy of Otolaryngology −Head and Neck Surgery
http://www.entnet.org/healthinfo/throat/tonsils.cfm
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Healthwise (Health Information Resource
Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/
This leaflet is for information only. For a detailed
opinion or personal advice, please consult with your own
doctor |
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