Tonsillectomy with (T&A) or without adenoidectomy: Tonsillectomy is the trans-oral removal of the two sponge-like organs on each side at the back of the mouth, where the soft palate divides into two pillars as it approaches the base of tongue. This can be accomplished using several accepted techniques, including sharp dissection, electrical cautery and radiofrequency ablation, and is performed under general anesthesia with brief intubation.
Intra-operative bleeding is usually modest. Postoperative pain is managed with around-the-clock pain medication for the first few days, after which medication can be taken on an as-needed basis. A regular diet is usually resumed by postoperative day 10 or 11. Patients are at risk for postoperative bleeding (3-5%) for the first 14-21 days after surgery, with days 5 to 10 being the most common. In children, postoperative bleeding usually requires a return trip to the operating room.
Adenoidectomy is the removal or ablation of the single tonsil that sits at the back of the nose (in the nasal pharynx). As with the tonsillectomy, this is performed through the mouth, and can be done sharply or with a radio-frequency ablation tool that liquefies the tissue. Intraoperative bleeding is usually minimal, and the postoperative bleeding rate approaches 0%. Adenoidectomy can also be performed alone in cases of isolated nasal obstruction or chronic sinusitis, or along with ear tube insertions (generally after tubes had already been inserted once, with recurrence of middle ear infections or fluid).
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