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Tonsillectomy is a common surgical procedure which involves the removal of the tonsils. The tonsils are a pair of soft glands found at the back of the throat. These glands can become enlarged, infected and painful, but these are usually relieved by medical treatment. In some individuals, especially children, tonsillitis may become recurrent and not responsive to medical treatment. Others also develop a chronic problem with swallowing or breathing because the tonsils are located in the part of the throat where air and food pass. In these cases, a tonsillectomy may be required.

A tonsillectomy is a short procedure that can be done on an outpatient basis. Children may require general anesthesia while adults may tolerate the procedure under local anesthesia. The most common post-operative complication from this procedure is pain or sore throat, which may last for a few days. It may also be difficult to eat and drink, which may result in dehydration if a child refuses to take anything. Small amounts of bleeding, ear ache and bad breath are also common.

Another post-operative complication from a tonsillectomy is voice change. This is often temporary, lasting for several days.

What causes a voice change after tonsillectomy?

Parents often observe that their children develop a higher voice after removal of their tonsils. This occurs because pain causes the muscles in the soft palate at the back of the throat to contract. This minimizes the pain but also affect voice quality. As the tissues heal, the throat muscles return to their normal state and the voice becomes normal again. This may take several days to a few weeks.

Rarely, hypernasal speech persists, especially if adenoidectomy is also done. This is a procedure which often accompanies tonsillectomy and removes the adenoids, or glands located at the roof of the mouth.

If this condition lasts for more than four weeks, medical consultation must be done. Speech therapy may help but sometimes surgery may be needed to correct the defect in the soft palate.

Home Care and Treatment

To relieve sore throat and voice change after tonsillectomy, patients are advised to drink plenty of fluids, soft foods like gelatin, custard, puddings and ice cream. Patients must avoid drinking acidic juices or eating coarse foods like chips, crackers or fresh fruit. Hot and spicy foods will also cause throat irritation and pain. Pain relievers may also be taken to reduce pain and improve appetite.

One should call a doctor when a sudden increase in bleeding from the nose or throat is observed. High fever (>101.5 F or 38.6 C) that persists even with adequate oral hydration and pain relievers may be a sign of infection and must be treated properly. Other signs and symptoms that may warrant medical attention include sharp pain in the throat and persistent headaches not relieved by pain relievers, difficulty breathing, severe nausea and vomiting, diarrhea, rashes, and bad breath with fever.

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