RECOVERY FROM TONSILLECTOMY

What is a tonsillectomy?

The tonsils are glands that sit on either side towards the back of the throat. They are made of lymphoid tissue and play a role in fighting infections. Sometimes they can cause problems requiring their removal. This operation is called a tonsillectomy.

More information on tonsil problems can be found here. You can find more information on when tonsils should and shouldn't be removed here, and techniques of tonsil removal (including coblation tonsillectomy) here. 

Tonsillectomy (removal of tonsils) is usually performed as a day case operation. In most cases, you will be able to go home six hours after the procedure. 

How long does the operation take?

The length of the operation can vary, but it usually takes about 15-20 minutes.

What happens after the operation?

After the procedure patients are taken from the operating theatre to the recovery room to wake up. When they are properly awake, they are taken back to their room. Patients normally need to stay in hospital for four to six hours before going home.

General anaesthetics affect people in different ways, and it can vary from person to person. It is not uncommon to feel tired; have trouble concentrating or feel your coordination is affected for 24 hours following surgery, so it is important not to drive or operate machinery; drink alcohol; sign important documents for this period of time.

It is normal to have a sore throat after the operation. This usually lasts for one to two weeks, although in children who have a coblation intracapsular tonsillectomy, it is often less. It is usual for the throat to become sorer for the first three to five days. After several days, some patients have sore ears. This is because the back of the throat and the ear share the same nerve supply, and this fact can fool the brain into thinking the pain is coming from your ears (this is known as ‘referred pain’).

It is usually helpful to take regular painkillers for the first week after your operation. After a week, painkillers can be taken as required. Usually, a combination of paracetamol and ibuprofen is sufficient to manage the discomfort, and I usually also recommend an anaesthetic spray such as Difflam for the first week. It is also important to make sure you drink plenty of water as being dehydrated can make the recovery more painful.

If you look at the back of your throat after the tonsils have been removed, you will usually see a white coating on the sides where the tonsils used to sit. This is a normal part of the healing process.

Occasionally the sound of your voice can change. In children, it sometimes becomes more high-pitched or even squeaky several days after surgery. This usually settles after a couple of days, and is caused by tightening of the muscles around the voice box.

After your operation, you should resume a normal diet, although it is best to avoid very spicy or hot food and drink. Whilst eating may be uncomfortable, it is advisable to have three meals a day, as this helps counter muscle spasm at the back of the throat, and can help you recover more quickly. It is often helpful to take painkillers about 45 minutes before eating. It is advisable to avoid alcohol whilst recovering from tonsillectomy.

When can I go back to work/school?

You should arrange to have two weeks off work, or clear of commitments after your operation. If you need one you can be given a ‘well note’ to give to your employer. Patients often ask if they can work from home after surgery. My advice is that whilst you can, it is often better to manage expectations by telling your employer or clients that you are not doing any work for two weeks. It is best to plan for children to have two weeks off school if the operation is performed in term time, although often they can go back to school after a week if they are eating normally and are back to their normal selves. It is best to avoid crowded places, to minimise the chance of catching a cough or cold. It is important that you do not exert yourself or undertake vigorous exercise for two weeks after surgery.

Can I brush my teeth after tonsillectomy?

Yes – dental hygiene is important after surgery. You should brush your teeth as normal.

Can I smoke after tonsillectomy?

Smoking causes inflammation of the upper airways and impairs the body’s ability to heal. Recovery from tonsillectomy will take longer, and the risks of surgery are increased. For these reasons, it is advisable not to smoke either before or after tonsillectomy. Even one or two cigarettes a day will have this effect. Stopping smoking can be difficult. If this is the case, nicotine patches can be a helpful alternative before and after tonsillectomy.

What should I do if….

My throat is very sore and I can’t swallow anything?

This is an unusual problem, and might be because you have developed an infection. You will need to be seen and have your throat examined. Sometimes stronger painkillers and antibiotics are required. If you are not able to swallow fluids, a hospital admission is sometimes required.

I have coughed up some blood?

It is common to have blood-stained saliva for the first 12 hours following surgery. If you have any bleeding beyond this point, or are coughing up fresh blood or clots, please attend your nearest Accident and Emergency department to have your throat examined. Please note that private hospitals do not have emergency departments, so you should not return to a private hospital if you have any bleeding after surgery. Most cases of bleeding after tonsillectomy are treated with mouthwashes and antibiotics. Rarely a further trip to the operating theatre is needed to stop the bleeding.

Contact Details

If you have any questions or queries either before or after your operation, please contact me at info@ent-care.co.uk or phone 01892 610737. If you have an emergency, please attend your nearest Accident and Emergency department. The hospital where you had your operation can also be contacted for advice.