To:

Dr James Deves
MB.BS., FRCS(Ed), FRACS
Ear, Nose and Throat Specialist
ABN: 43 002 215 643
Provider: 090025K
29 Hill Street Gosford NSW 2250 Operating at:
TONSILLECTOMY AND ADENOIDECTOMY

Tonsils are a mass of lymphoid tissue on either side of the back of the mouth. The tonsils
are concerned with protection against infection. The adenoids are the same type of tissue at
the rear of the nose. Enlargement of the adenoids can cause can cause obstruction to
breathing through the nose and can block the Eustachian tubes causing glue ear.
Tonsillectomy is commonly performed for recurring or chronic tonsillitis, for enlarged tonsils
causing breathing obstruction (apnoea) and for cancer of the tonsil. Adenoidectomy is
needed when the adenoids get infected at the same time as the tonsils, or they are enlarged
causing obstruction at the back of the nose or cause ear infections. A general anaesthetic
and an overnight stay in hospital are required. The operation is done through the mouth and
there are no external excisions.

POST OPERATIVE CARE
When patients wake up from this operation they will have an IV cannula normally
somewhere in their arm that is used to give IV fluids. The throat is normally sore, and it is
important to have regular pain relief to make eating and drinking more comfortable. A soft
diet is recommended initially as this will be easier to tolerate, but a normal diet can be eaten
as soon as desired. The IV cannula is normally removed the next day before discharge from
hospital. Antibiotics will be prescribed to take after surgery.

PAIN RELIEF
Adults will be prescribed analgesia in tablet form and liquid pain relief is better tolerated for
children. Panadol elixir (there are several other brands on the market as alternatives e.g.
Dymadon is a thick mixture that may be tolerated easier) or Painstop (there are two types –
day, and night is recommended before bed as it contains promethazine and this may help
with sleep) should be taken regularly as directed and may be required for at least 10 days
post-op. ASPIRIN OR DISPRIN MUST NOT BE USED and neurofen is not recommended. If
there are any problems with pain relief please contact the rooms for advice. Cepacaine
mouthwash is also suggested for adults and older children as this contains some anaesthetic
and may help with the pain. This can be diluted with water if full strength is not tolerated. At
home it is important to eat and drink plenty of fluids as failure to do so can cause excessive
pain. It is important that the throat remembers how to swallow or it can become tight and
painful. Good oral hygiene is also encouraged. The breath may become smelly and a white
coating form on the throat where the tonsils were. Pain may also be felt in the ears. This is
all part of the normal healing process.
If you experience excessive pain, discharge, bleeding from the ear, or any other symptoms
that concern you, please contact the rooms during business hours (02 4324 5677). After
hours, please contact the hospital where you had your surgery (NGPH 02 4324 7111 or
BVPH 02 4389 1970) and talk with the staff as they can contact Dr. Deves if there are any
problems.

Source: http://www.entgosford.com.au/docs/Tonsilectomy%20and%20Adenoidectomy.pdf