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We help children and families
be their healthiest
Tonsillectomy
(with or without Adenoidectomy)
What are the tonsils?
The tonsils are two pads of tissue located on either side of the back of the throat.
Tonsils can become enlarged after recurrent tonsil infections or strep throat. They can also
become a reservoir for bacteria.
Why does my child need a tonsillectomy?
During a tonsillectomy, the tonsils are removed during surgery. Some children may need a
tonsillectomy if they:
• Have tonsil infections or strep throat often.
• Have large tonsils that block their airway. Large tonsils can make it hard to breathe,
and can even cause pauses in breathing (apnea).
Tonsils
Getting Ready for Surgery...
1. For 1 week before surgery make sure your child does not take ibuprofen or
anti-inflammatory medications. Do not give:
• Advil® or Motrin® (ibuprofen);
Adenoids
• Aspirin®, Aleve® (ASA);
• Naprosyn®;
• Gingko ;
Tonsil
• St. John’s Wort.
Base of skull
Nose
Nasal cavity
Tongue
Lips
2. You may give acetaminophen (Tylenol® or Tempra®), over the counter cold
medications or antibiotics as needed.
Spine
3. Please tell your doctor if your child bruises easily, or if anyone in your family
has had:
• Problems with an anesthetic;
• Bleeding tendencies.
Teeth
Palate (roof of mouth)
Trachea
(Windpipe)
Esophagus
4. After the surgery, we recommend that you stay:
• Within 1 hour of CHEO for the first night.
• Within 3 hours of a hospital that can deal with tonsillectomy patients for the 14 days after surgery. If you live outside of Ottawa, you’ll have to plan ahead. You may stay with friends or family. You may also book a
room at Rotel (a reasonably priced hotel on the CHEO campus) by calling 613 733-1412.
What happens during surgery?
Your child will have a general anesthetic (special sleep medicine) for the tonsillectomy. Most patients go home the
same day. Some patients must stay in hospital overnight so we can watch them carefully. Adenoids are also often
removed during the surgery (adenoidectomy). The surgery takes 30 – 45 minutes. Children usually stay at CHEO for
2 – 4 hours after surgery, unless they are staying overnight for observation.
Form # P5642E
September 2013
www.cheo.on.ca
Taking care of your child after surgery
It takes most children 10-14 days to recover after a tonsillectomy.
Breathing:
After surgery, there is some swelling, and it’s normal for children to snore and breathe through their
mouths. They may also talk a little differently. You may also notice that your child has bad breath. This is OK-it’s caused
by white scabs that form in the throat as the throat heals.
Pain: Most children have a fair bit of pain in the ear or throat after surgery.
It may get worse on the 5th day after
surgery. They may also complain of neck stiffness. If neck stiffness lasts more than 2-3 days after surgery, contact your
doctor. Many children have trouble eating, drinking and sleeping because of pain. Pain medication may be needed for as
long as 7-10 days.
Fever:
A low grade fever is normal for a few days after surgery. Give acetaminophen (Tylenol®) as needed. Please
call the surgeon’s office if the temperature is 39°C (102°F) by mouth, or higher.
Nausea and Vomiting:
Some children have nausea and vomiting after the general anesthetic. This should get
better within a few hours. Please call the surgeon’s office if nausea and vomiting lasts for more that 12 - 24 hours.
Diet:
It is important to drink plenty of cool fluids. Some
children do not want to drink because of pain. Begin with a clear
liquid diet, progress to a soft diet, and then to a normal diet as
your child feels like eating. Please call the surgeon’s office or go
to the CHEO Emergency Department if you are worried that your
child is not drinking enough or if there are signs of dehydration
(peeing less than 2 – 3 times per day, crying without tears).
Preventing dehydration
Your child should drink close to:
_________ each day, or
_________ every waking hour, or
_________ every 15 minutes (if she is resisting fluids).
Medication:
• Give Tylenol® every 4–6 hours. Do not give more than 5 doses in a 24 hour period.
• Morphine or other pain medication may be prescribed. These medications can cause nausea, abdominal pain and
constipation. You should never give more medication than prescribed.
• You may give anti-nauseant medication, like dimenhydrinate (Gravol®). Stool softeners are often helpful.
• Avoid NSAID drugs like Ketorolac (Toradol®).
Activity:
Children may return to school when they are eating and drinking normally, off of all pain medication
and sleeping through the night. Your child can go back to light activities as soon as your child feels ready. Your child
should wait for 2 weeks (14 days) before taking part in more vigorous activities like team sports. Your doctor will tell
you about any other limits to activity.
Bleeding:
There should not be any bleeding from the mouth or nose after surgery, although some pink saliva is
normal. Children are at risk for bleeding for up to 14 days after surgery. Please do not travel away from a major
hospital for 2 weeks after surgery. If bleeding occurs, bring your child to the Emergency Department to be checked by
the doctor on call. Call 911 if the bleeding is severe.
Emergencies after hours
In an emergency: call Ontario Tele-Health
(1-866-797-0000), go to an after hours
clinic or to CHEO’s Emergency Department.
Evenings: (5pm-8pm): CHEO Reception (613) 737-7600.
Ask for the On-Call E.N.T. doctor. Call between 8am-4pm MondayFriday for a follow up appointment in several weeks after surgery.
Drs. MacCormick, Vaccani, Bromwich, Schramm:
(for clinic or telephone follow up): (613) 737-7600 extension 2009
(Nurse, extension 2587)
Drs. Girard, McLean, Scherer, Henry: (613) 562-9000
Dr. Antoniak 613-521-3223
Dr. Matyas 613-727-3132
Dr. Murphy 613-235-0469
Dr. Kherani 613-526-5737
www.cheo.on.ca
Dr.
Dr.
Dr.
Dr.
Odell 613-737-8899 X 73287
Planet 613-746-2235
Kilty 613-729-2312
Macdonald 613-729-2834