Tonsil and Adenoid Removal Surgery For Children (Surgery - What to Expect)

Member Name: ickleannie

Product:	Surgery - What to Expect
Date:	14/02/09 (402 review reads)
Rating:

Advantages: Benefits For The Future

Disadvantages: Painful Distressing Experience

As some of you already know I am a nurse who currently works in the area of general medicine. I tend mostly to deal with adults, and the patients that I see come in with a wide variety of illnesses and ailments. I'm not sure why but nursing other people comes naturally to me however when it comes to dealing with my own family members and illness it is a completely different story. While undergoing my nurse training I had the opportunity to witness a variety of operations from the simple removal of moles right up to advanced triple heart bypass surgery. Anyway I am going off in a complete tangent at present so I will get to the point. Please be advised that this review is being looked at from the perspective of being both a parent and a nurse.

My six year old son has had problems with enlarged tonsils and adenoids which has resulted in him for the most part of his young life snoring like a train at night and breathing like Darth Vader. After much thought it was decided with the help of his consultant that it would be advantageous if he was taken into day surgery to have both removed. It was not a decision taken lightly. I have to confess that I have been party to witnessing this procedure with adults and it is not pleasant. However my husband and I agreed to surgery as we would not wish him to have problems when older with infected tonsils and adenoids as this can be extremely serious and painful on removal in adulthood.

Due to his age it was decided that my son would be admitted to the childrens day surgery unit in the early morning a few hours before he was to have his elective surgery. After which he would be monitored overnight in a childrens ward. I was able to stay with him throughout the whole experience minus the surgery however if the truth be known there would be no way that I could have witnessed this being done to my beautiful little angel. I actually had to block out of my mind what was actually happening to him when he was in theatre!!. On arrival we were met by a series of healthcare professionals who examined my son and asked the usual medical and pre-assessment questions. Just to ensure that he was fit for surgery and hadn't for safety reasons had anything to eat or drink after seven thirty in the morning. Being a children's hospital he was extremely relaxed and was given a pre-med which kept him calm prior to surgery, he then popped his pyjamas and dressing gown on which he found very novel during the day. You don't want to scare your children unnecessarily so I told him that he would be put to sleep and would wake up with a bit of a sore throat!! Each child will be able to handle information in different ways however I would suggest that you don't unnecessarily worry them. The facilities available in our local children's hospital were second to none. He spent most of his waiting time playing computer games and interacting with some other children who were in for the same procedure.

Then his name was called and I must admit I was more upset than he was. They let him drive an electric quad bike down to the operating theatre which I thought was a lovely touch. I was allowed to go in with him while he was getting anaesthetised. This is where they insert a cannula into one of the veins on the back of the hand. Anaesthetic gel had already been put on the back of his hand several hours before to numb it so trust me although it nips slightly it is not too distressing for the child. They also have the benefit of your presence which is a further comfort to them as it can be quite a scary experience for a small child. Anaesthetic is then administered via syringe into the cannula and within a few seconds your child goes off to sleep. This was a part I had forgotten about and they go off so quickly that it can be a bit startling if you are not expecting it. At this point theatre staff escort you out and you go off up to the ward to wait for your child coming out of surgery.


Tonsils are little glands which are found at the back of the throat, there are two, one on each side. The function of tonsils is to fight germs when young. After three years old the tonsils are not required for this function and usually shrink. The body is capable after this age of fighting infection without them. Removal of tonsils is only required if they are doing more harm than good. This is normally if your child is getting lots of sore throats or the tonsils are becoming infected. Another reason which was why my son was in hospital was because his tonsils had become so big that they were inhibiting his breathing at night. There are several methods available to a surgeon for tonsil removal. A special blade can be used to cut out the tonsils, after which pressure is applied to stop the bleeding and dissolvable stitches or heat is used to seal the wounds site. Laser or ultrasound waves can also be used. High energy waves are used to cut out the tonsils and seal the blood vessels which will stop the bleeding. More commonly now however they use diathermy which was the procedure used for my child. This is where heat from an electric current is used to cut out the tonsils and seal the blood vessels afterwards.

Adenoids are very small glands which are found in the throat, located at the back of the nose. Like tonsils there function also is to fight infection and again after three years of age they are no longer required as the body can fight infection without them. Adenoids are only taken out if absolutely necessary, reasons for this are due to, them causing a blockage in the nose which makes the child breathe through their mouths. Snoring at night can also be a major factor. In severe cases they can cause children to stop breathing for a few seconds while sleeping. In addition adenoids can cause ear problems and infection. The surgeon uses a series of surgical instruments to remove the adenoids from the back of the throat via the mouth. A gauze pack is then pressed on the area to stop blood vessels near the adenoids from bleeding. When the bleeding stops the pack is removed and the operation is finished.

You will be waiting in the ward for your child and a nurse will escort you back to theatre where you will see your child in the recovery area. Be advised it is important to remain strong for your child as they will inevitably be very distressed and unfortunately in pain. Although anaesthesia is given pain is often only managed and cannot always be fully eradicated. My heart was broken when I saw my son it was so upsetting but I knew that all of this would benefit him in the next few weeks and months and ultimately improve his adult life. In the ward he was given further pain killers and a drip which replaced some of the fluids which had been lost not only during surgery but also as he had had nothing to eat since 7.30 in the morning. Fluids and eating are actively encouraged however it will take some time before they will be able to tolerate this as they will have an extremely sore throat. Do not panic or force food on them though they will eventually start eating. They will be kept in overnight to ensure that there is no further bleeding or complications. This stay could be extended slightly if problems occur or there is a refusal to eat. Be advised that you will need to arrange to have your little one off school for 10-14 days.

After surgery your childs throat will be very painful, it will however get better day to day and each child is different. The best way to combat this is to ensure that the prescribed painkillers given are administered regularly. It is wise to give them half an hour or so before meals for the first few days to ensure that they can eat with as little distress as possible. Eating is important as it will help the healing process in the throat. This will also ultimately help the pain. Drinking is vital too, and should be actively encouraged. Painful ears may be experienced this is because the ears and the throat have the same nerves. Don't panic if this is the case there shouldn't be any infection in the ears. The back of the throat will look white after a day or so this is normal and don't worry as it is part of the normal healing process of the throat. Some children may get a throat infection after surgery, this is normally due to them not eating normally. You may notice a fever and a bad smell from your child's throat if this occurs contact your GP or the hospital for advice. Finally if you become aware of any fresh bleeding from the throat seek medical advice immediately as this bleeding could be serious.

My son was discharge from hospital the day after his surgery. He was extremely sore for a few days afterwards however this did subside. Eating was slow to start with but gradually this was built up day by day and he was back to normal and demanding sweeties three or four days later. I would recommend giving the medicine before meals as this really did help. The major problem is boredom as for the first few days it is important to keep them as still as possible not an easy task to implement for a six year old. They are however a bit sleepy for the first couple of days so this helps. Do not let them play with other children and shield them for a few days from going outside or anywhere they could pick up coughs colds or infections.

I appreciate that this can be a distressing operation especially as the children are so small however the benefits ultimately out-weight the negative aspects. The beauty of children is that they bounce back quickly and they should not experience any further problems in the future. Distressing but worth it to prevent health complications in the future.

Summary: Removal Of Tonsils and Adenoids