Showing posts with label Tonsils. Show all posts
Showing posts with label Tonsils. Show all posts

Tuesday, 8 May 2012

POST TONSILLECTOMY CARE


TONSILLECTOMY
Tonsillectomy is a surgical procedure to remove the tonsils which are lymphoid tissues situated at the back of the throat. It is recommended when the patient has repeated tonsillitis, enlarged tonsils, suspicion of tumour or peritonsillar abscess. The surgeon would only advise for tonsillectomy when the benefits of the procedure outweigh the possible risks and complications. Tonsillectomy is performed under general anaesthesia via trans-oral approach; that is through the mouth opening.
Typical appearance of the back of the throat three days post tonsillectomy
(Wikipedia.org)

COMPLICATIONS OF TONSILLECTOMY
Bleeding- the tonsil area has a rich blood supply and care is taken to stop any bleeding intraoperatively. The risk of bleeding after tonsillectomy is very low and usually present with blood stained saliva. On rare occasions the bleeding can be severe and have to be managed in the operating theatre. Risk of bleeding is higher when there is infection.

Infection- it is a potential risk especially in patients with inadequate food and fluid intake after tonsillectomy. Patients with infection post tonsillectomy will have symptoms of severe throat pain and bleeding. Treatment is mainly antibiotics and may require re-admission.

Injury to lip/mouth- instruments are inserted to help open up the mouth during surgery. There is a small risk of injury to lip, mouth or teeth during this procedure.

POST OP CARE
  • Pain post tonsillectomy can be severe and lasts up to 2 weeks. However in children the recovery is much faster usually within 1 week. Sometimes the pain can get worse between 3 to 5 days after the surgery before it gets better. Patients are advised to take their painkiller medication regularly.
  • Swallowing can be difficult after surgery because of the pain. However patients are encouraged to drink and eat as soon as they wake up after surgery. It may be easier to take cold fluids and soft food initially. Taking small sips of fluids may be easier than big swallows. Avoid taking any spicy or hot food to reduce risk of bleeding. Eating well would also lead to better and faster healing of the operated area.
  • Avoid going out to public places. Patients are advised to rest at home for about 1-2 weeks. This can prevent exposure to infection.
  • Small amounts of blood stained saliva can be normal in the first 2 weeks and can be stopped with ice gargles. However if bleeding is continuous and increasing in amount, do seek immediate medical attention at the hospital where the surgery was performed.
Printable patient leaflet

Sunday, 11 September 2011

Should the tonsils be removed?

The above question is often heard during consultation at the ENT clinic. The patient goes through a rollercoaster of thoughts when their doctor suggests an operation. What more when a parent has to make the decision on behalf of their child.

What are tonsils?


Tonsils are lymphoid tissues at the back of the throat which form a part of the immune system. It grows rapidly between the ages 2 to 6 years and then slowly regress with age. However it is not unusual for tonsils to get infected resulting in a condition called tonsillitis with symptoms of severe sore throat and fever.

When is tonsillectomy advised?
Common indications include
       Recurrent or Chronic tonsillitis; more than 3-5 episodes in a year
       Enlarged tonsils causing airway obstruction or snoring
       Suspicion of tumour; ulcerated tonsils or unilateral tonsil enlargement
       Peritonsillar abscess

How is tonsillectomy performed?
The patient is given general anaesthesia and the tonsils are removed via the mouth. At times other procedures are also indicated such as adenoidectomy depending on the patient's history and ENT examination.
Complications associated with tonsillectomy is minimal. Patients are informed of pain on swallowing and advised to take soft cold diet immediately after surgery. And return to normal diet till healing is complete. This normally takes about 7-10 days. Patients are also informed about the possibility of post tonsillectomy bleeding.

Tonsillectomy is a simple operative procedure. What is more important is the correct selection of patients. The immune function is not affected after tonsillectomy as there are other lymphoid tissue in the throat area.