How long uvula swollen after tonsillectomy

When you can eat, start with soft, cool foods for the first week like yogurt, pudding, and scrambled eggs. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Cleveland Clinic. Tonsillectomy: treatment, risks, recovery, outlook. Updated March 6, Cooper L. Post-tonsillectomy management: A framework. Aust Fam Physician. Airway obstruction caused by massive swelling of the tongue following bilateral tonsillectomy for sleep apnea syndrome.

Masui the Japanese Journal of Anesthesiology. Accessed April, Kinthala S, Kumar Areti Y. Airway obstruction and inability to ventilate due to swollen uvula following adenotonsillectomy in a three-year old child. West Indian Med J. Tonsillectomy and the risk for deep neck infection-a nationwide cohort study. PLoS One. Halitosis and the tonsils: a review of management. Otolaryngol Head Neck Surg. Postoperative complications following tonsil and adenoid removal in Kuwaiti children: A retrospective study.

Ann Med Surg Lond. Tonsillectomy in children: Update to guidelines for treating and managing care. Published February 5, The effect of tonsillectomy on obstructive sleep apnea: an overview of systematic reviews. Nat Sci Sleep. Windfuhr JP. Serious complications following tonsillectomy: how frequent are they really?

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Table of Contents View All. Table of Contents. Swollen Tongue. Swollen Uvula. White Scabs. Bad Breath. Symptoms and Risks After Tonsillectomy. Follow Up. Bleeding After a Tonsillectomy Is an Emergency. Frequently Asked Questions Does having your tonsils removed hurt? These patients are at higher risk of opiate toxicity. Non-pharmacological treatments for pain are often forgotten. Many modalities have been shown to reduce pain; however, due to small numbers of research papers, they are excluded from recommendations.

These include distraction, honey and ice. If children are struggling to eat and drink, and dehydration is a concern, oral rehydration ice-blocks are advisable. Refusal of all oral intake, including analgesia or despite analgesia, should be referred to the hospital where the surgery was performed for ongoing management.

Halitosis is a common presenting complaint to GPs post-tonsillectomy and is one of the most common symptoms leading to inappropriate antibiotic prescription. Chewing gum may improve halitosis for those concerned. Patients and parents often become concerned with the postoperative appearance of the tonsillar fossae as the white-yellow slough is often confused for pus.

This appearance is due to inflammatory exudate and a fibrin clot developing over the tonsillar fossae. Uvula oedema is common after tonsillectomy and can be the result of forceful manipulation during the operation or the disruption of lymphatic or venous supply during dissection of the tonsils.

Oedema typically resolves spontaneously within a few days; however, oral steroids may be required in severe cases. Bleeding is one of the most common presentations to the GP 2 and emergency department post-tonsillectomy. In rare cases, bleeding can be catastrophic. Patients are encouraged to present to the emergency department if bleeding occurs; however, many still present to their local doctor.

One recent study looked at which patients required intervention in order to identify those who may not require hospital admission. If there is any active bleeding or large clot sitting within the tonsillar fossa, the patient should be immediately sent via ambulance transport to the emergency department for admission and intervention.

All patients with a history of bleeding should be referred to the emergency department; however, those who have a normal oropharyngeal examination ie no active bleeding or clot in the tonsillar fossae, with the usual tonsillar slough only may be counselled by the emergency department with no need for admission.

Arora et al found no patient with a normal oropharyngeal examination after initial bleeding required intervention for further episodes of bleeding. In addition, children under six years of age are at lower risk of developing any significant haemorrhage. It is important to advise the patient and family that in the event of further episodes of bleeding they should present to the emergency department.

All patients should be encouraged to rest and remain adequately hydrated. Diagnosing infections in post-tonsillectomy patients has previously been identified as a clinical dilemma for GPs due to a lack of understanding of the normal postoperative appearance and common postoperative symptoms. Although still controversial, it is suggested that a persistent fever accompanied by either increasing pain despite analgesia or cervical lymphadenopathy may indicate an infection and antibiotics would be appropriate.

Despite written and verbal education given to tonsillectomy patients and their family prior to discharge, many still present to the emergency department and local doctor for postoperative concerns. This article has addressed the management of common presenting complaints in the hope of providing guidance for the GP.

Better understanding of the common postoperative concerns will improve treatment decisions, advice and education of patients, and is likely to decrease inappropriate antibiotic prescription. Competing interests: None. Provenance and peer review: Not commissioned, externally peer reviewed. Australian Family Physician. Search for: Search AFP. Filter Relevance Date. Issues by year.

Volume 45, Issue 5, May Background Despite written and verbal education, many post-tonsillectomy patients have a lack of understanding of common postoperative symptoms. Combined with a significant decline in the length of hospital stay, this has resulted in many presentations to the general practitioner GP. Prior research has found there was often difficulty with diagnosing postoperative infection, compared with normal postoperative symptoms, which has ultimately led to an over-prescription of antibiotics.

Previously, GPs have requested a framework to manage these patients. Objective This article aims to address many of the common reasons for presentation to a general practice post-tonsillectomy, and provide a guideline for managing these common presenting complaints. Discussion Many of the signs and symptoms that have previously prompted antibiotic prescription for suspected infection are part of the normal postoperative course.

However, if there is high clinical suspicion of infection then a course of antibiotics would be reasonable. Common presentations Fever Fever within the first 24—48 hours is not uncommon post-tonsillectomy. Pain Moderate to severe pain is expected post-tonsillectomy and is the most common presentation to GPs.

He received general anesthesia. On laryngoscopy, his Cormack-Lehane grade was 1. The trachea was intubated easily with 8 mm internal diameter cuffed polyvinyl chloride tracheal tube using Macintosh laryngoscope blade size 3 after intravenous iv induction of general anesthesia with midazolam 1. At the end of surgery that lasted for 2 h, neuromuscular blockade was reversed with glycopyrrolate 0. The trachea was extubated once the patient was awake, and he was shifted to the recovery room.

Two and a half hours following surgery, an anesthesiologist was called as the patient complained of severe discomfort in the throat. He had foreign body sensation like a lump in the throat which was irritating the tongue with pain on swallowing his saliva.

His vital signs were stable, and there was no clinical evidence of airway compromise or allergic reaction. On examination of the oral cavity, the uvula was much elongated around 3.

Adjacent oropharyngeal structures palate, tonsils, and pharynx were normal. The patient was reassured and given iv dexamethasone 8 mg and chlorpheniramine maleate 25 mg.

He was advised warm saline gargles six-hourly interval, iv antibiotics, and two more doses of dexamethasone 8 mg, diclofenac sodium 75 mg, and acetaminophen mg at eight-hourly interval. Postoperative complete blood count was normal.

Patient was symptomatically better the following day. The patient was discharged home as the uvular edema regressed after 48 h, with the uvula regaining its normal appearance. The event delayed the discharge of the patient from the hospital by 24 h. Postoperative sore throat is a common morbidity following endotracheal intubation. On postoperative visit, the patient gave history of upper respiratory infection 2 weeks back for which he took antibiotics, but it was not revealed by the patient at the time of preoperative visit.

He was symptom-free at the time of preoperative visit, and his airway examination was unremarkable. Trauma to the uvula might have occurred by direct pressure from the endotracheal tube though it was fixed at the angle of the mouth on the right side away from the midline. Other possible etiologies might be trauma from laryngoscope blade or blind suctioning at the time of extubation. Other medical causes of uvular edema are infections bacterial or viral , allergic or hereditary angioneurotic edema were not responsible in the present case.

Postoperative uvular edema has been reported in a child after general anesthesia via a laryngeal mask airway Huang and Chui and following tonsillectomy in a child with a history of obstructive sleep apnea Nasr et al.

It has also been described in two adult patients undergoing upper limb surgery under interscalene brachial plexus block with deep intravenous sedation as a result of intraoperative snoring Neustein ; Miller and Gerhardt There was also a report of acute uvular edema leading to postoperative airway obstruction and admission to hospital in a healthy young adult who inhaled marijuana prior to general anesthesia after an uneventful general anesthesia Mallat et al.

Postoperative swollen and elongated uvula after general anesthesia occurred in a patient in a prone position as a result of possible mechanical trauma Rempf et al. Uvular necrosis is reported after an otherwise uneventful intubation and anesthesia Atkinson et al. The patient was conservatively treated with analgesics and antibiotics and made a complete recovery.

Complete airway obstruction after extubation occurred in a child after traumatic adenoidectomy due to uvular edema leading to tracheal reintubation Tabboush Significant uvular and oropharyngeal ulceration has been described in two patients during routine transesophageal echocardiography while intubated under general anesthesia Nijjer et al. The aim of this case report is to create awareness among anesthesiologists that uvular edema can manifest in the postoperative period as a distressing complication.

It is to be considered in the differential diagnosis of postoperative airway obstruction and sore throat particularly if associated with a foreign body sensation or difficulty in swallowing. Diagnosis can be made by prompt oral cavity examination. Steroids and antihistamines are the main stay of treatment along with antibiotics and topical adrenaline administration in selective cases Raux et al.

As uvular edema can lead to extreme distress to the patients, they should be given an explanation of the condition, reassured that the symptoms would resolve within a few days, offered treatment, and followed up. Severe cases with airway obstruction may need tracheal intubation.