Tonsillectomy in Children | Hull University Teaching Hospitals NHS Trust

This leaflet has been produced to give you general information about your procedure. Most of your questions should have been answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

About tonsillectomy

When your tonsils are taken out, it is called a tonsillectomy. This leaflet lets you know what to look out for when your child has had their tonsils taken out. There are some useful tips on what to expect and who to contact in an emergency. Tonsils are usually removed either because of recurrent infections or problems with breathing when asleep.

How long does my child need to stay in hospital?

Before your child’s operation, your surgeon will talk to you about the surgery. Together, you will decide if the operation can be done as a day case. This means your child will be able to go home later the same day. If you live a long way from the hospital, your child may not be able to go home the same day. If the surgery cannot be a day case, your child will need to stay in hospital overnight.

Day case surgery

Before your child goes home, the doctors must keep an eye on their recovery. For a day case, there must be enough time for this on the same day. It will be at least three hours after the operation before your child is able to go home.

There are set goals that your child must reach before going home. The nurse looking after your child will check how they are doing after surgery. If they meet the goals, they will be able to go home.

What problems could I see after the operation?

Tonsil surgery is very safe, but there are risks to all operations. Your surgeon will tell you about the risks before the operation.

Bleeding

The most serious problem is bleeding. Bleeding can happen at any time in the two weeks after the operation.

Go straight to your nearest A&E department if your child has any of the following:

Spitting out bright red blood or clots.
Difficulty breathing.
Vomiting bright red, black or brown vomit. This could be blood and needs to be checked.

About six children out of every 100 who have their tonsils out will need to go back to hospital because of bleeding. One child out of every 100 will need a second operation to stop the bleeding.

Sore Throat

Your child will have a sore throat for up to two weeks. Pain is often at its worst around 6 days after the operation. It is important to give your child pain medication every day, following a regular pattern.

Make sure that you have enough medicine at home (Paracetamol and Ibuprofen and Difflam Spray) and that you know when to give it.
Some children with asthma cannot take ibuprofen.
It is best to give the medicine half an hour before meals for the first few days.
Do not give more than it says on the label.
Do not give your child aspirin. Aspirin could make your child bleed. It is not safe to give to children under 16 years old at any time, unless prescribed by a doctor.
You may be given a small amount of Oral Morphine to take home (up to 12 doses). This can be used (as per the instructions) if your child is still in pain after giving paracetamol and ibuprofen.
Any unused oral morphine should be thrown away after 2 weeks.

Sore ears

After a couple of days, your child might complain about sore ears. This is normal. It happens because your throat and ears have the same nerves. It does not usually mean that your child has an ear infection.

Swelling of the uvula

The dangly bit at the back of your child’s throat, called the uvula, can swell up after the operation. They might feel like they have something stuck at the back of their throat. This gets better within a few days.

Infection

Look out for throat infections in the two weeks after the operation. Fever is common in the first 24 to 48 hours after tonsillectomy. This happens to up to half of patients. A high temperature of 38oC (100oF) or more should not need antibiotics if it quickly goes back to normal. If the fever does not go down, it could be caused by an infection.

Often when children get a throat infection after surgery, they have not been eating properly. If this happens, you may notice a fever and a bad smell from your child’s throat. Call your GP or the hospital for advice if this happens. Your child may need a course of antibiotics if they have an infection.

Damage to teeth, lips and gums

The instrument used to keep your child’s mouth open during the operation sits on the teeth. Please let us know if they have any loose teeth.

Why does my child’s throat look white?

The white colour is normal while the throat heals. It is not pus and you do not need antibiotics.

You may see small threads in your child’s throat. These are sometimes used to help stop bleeding during the operation and fall out by themselves.

What kind of food should I give my child after the operation?

Eating normal food will help your child’s throat to heal. It will help the pain as well. There is less chance of bleeding or infection if your child eats as normally as possible. Always give your child a drink with every meal. Chewing gum may also help the pain.

Some children will not want to eat or drink after the operation. Sometimes they might get dehydrated. If that happens, your child might need to go back to the hospital for help with hydration and nutrition. This happens in about three out of 100 children.

How long should I keep my child off school?

Your child may feel tired for the first few days and should stay at home for 10-14 days. Make sure they rest at home, away from crowds and smoky places. Keep your child away from people with coughs and colds.

Can my child brush their teeth?

Yes. It is important to brush the teeth after the operation, to keep your child’s mouth clean.

Will my child need to be seen in the clinic after the operation?

No. We will tell you before you go home if an appointment is needed.

Who do I contact if I have problems in the two weeks after my child’s tonsils are taken out?

Please contact Acorn Ward tel: 01482 382703 or your GP if your child has any of these problems:

Difficulty swallowing liquids.
Pain relief does not stop the pain.
A fever of 38oC/100oF or more that will not go away.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the ENT Department.