The tonsils are soft tissues found on each side at the back of the throat, while the adenoids are found high in the throat, at the roof of the mouth behind the nose. These tissues may become inflamed and enlarged due to an acute viral or bacterial infection, but they may also be chronically enlarged due to on-and-off infections, thereby blocking the passage of food and air into the throat.
Tonsillectomy and adenoidectomy are surgical procedures often performed in children who are suffering from obstructive sleep apnea (OSA) that is related to chronically enlarged tonsils and adenoids. These are also done in patients who have recurrent tonsillitis that does not improve with conventional medical therapy such as antibiotics, and in those who have difficulty eating and breathing due to mechanical obstruction caused by the enlarged glands. They are less commonly done in adults, but may be effective in specific cases of OSA caused by enlarged tonsils and adenoids.
Tonsillectomy and adenoidectomy are relatively short, simple and safe procedures, but post-operative pain may be severe. Other possible immediate complications of tonsillectomy and adenoidectomy are bleeding, nausea and vomiting, difficulty in breathing and other complications related to anesthesia. Because of these, patients are usually confined to the recovery room for a few hours until they are fully awake and have recovered from the effects of the anesthesia and surgery.
Tonsillectomy and adenoidectomy can cause a severe sore throat that can lead to difficulty in swallowing, which may last for two to three weeks. Ear pain may also be experienced. Patients are often prescribed pain relievers and advised to eat and drink soft or liquid cold foods like ice cream. Dehydration from lack of fluid intake and bleeding can also occur, since feeding and drinking are decreased because of pain and discomfort. Sleep can also be disturbed in some patients due to swelling in the throat. To avoid these, pain medications must be taken round-the-clock at proper doses until symptoms get better and one is able to eat and drink adequately. Citrus fruit drinks, hard or crunchy foods, such as chips and cereals, must be avoided to prevent throat irritation.
Aside from pain, it is common for patients to observe some blood in their saliva for several days. This usually consists of spots, but not fresh, dripping blood from the nose or mouth.
Spotting in the saliva may occur for up to two weeks as crusts fall off while the tissues heal. Mucus crusts and scabs are normal during the healing process, and these may lead to bad breath. Because of pain, it may also be hard to expectorate or remove the mucus from your throat by coughing it out. However, it is not advisable to gargle or remove the scabs because these can cause further bleeding. These symptoms are expected to improve within two to three weeks.
If your symptoms do not start getting better after a few days or if you feel they are getting worse, consult a doctor for proper evaluation and treatment.
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