PATIENT INFO
Throat Leaflets

After your child’s tonsil surgery: tips for parents
After a tonsillectomy, your child may experience a sore throat, requiring regular painkillers for relief. This allows them to resume a normal diet, including bread. A two-week break from school and social activities is necessary for proper recovery. Although there is a one in six chance of post-surgery bleeding, prompt attention at the nearest A&E department is crucial if it occurs. In rare cases, one in 100 children may require a second operation to address bleeding. This e-leaflet provides guidance on recognizing and managing symptoms, as well as emergency contacts for additional support after your child’s tonsillectomy.
Flexible Nasal Endoscopy
Flexible nasal endoscopy is a routine procedure utilized to examine the interior of the nose, the nasal passages, the larynx, and the posterior regions of the throat and tongue. This involves the use of an endoscope, a flexible type of telescope. The procedure is commonly conducted in outpatient clinics, hospital wards, or emergency departments. Individuals experiencing issues with the ear, nose, throat, or voice box may undergo this examination. The endoscope, equipped with a bright light, is a narrow and flexible telescope. In standard fiberoptic endoscopes, the image is transmitted through numerous fine glass fibers to an eyepiece or camera. Alternatively, some endoscopes have a video camera at the tip, displaying the captured images on a screen.
Helping you decide about tonsil surgery for your child
Tonsils, situated on either side of the back of the throat, can become inflamed, leading to tonsillitis, often caused by viral or bacterial infections. This common childhood illness typically manifests with symptoms like a sore throat and fever. To alleviate your child’s discomfort, you can administer paracetamol (e.g., Calpol), ibuprofen, or a combination of both. Additionally, soothing treatments like over-the-counter throat lozenges and sprays are beneficial if age-appropriate. Gargling with a mild antiseptic or warm, salty water can provide relief. In most cases, symptoms improve within a week.
Hoarseness
Hoarseness or Dysphonia denotes a alteration in the sound of one’s voice, characterized by a strained, husky, or breathy quality. Individuals experiencing hoarseness may observe changes in loudness and variations in voice pitch. In young children, fluctuations in voice pitch are common during puberty, often referred to as voice “breaking.” Aphonia, a condition marked by a complete loss of voice resulting in only a whisper, is another manifestation. Hoarseness arises when the vocal cords in the larynx, responsible for producing sound through vibration, do not function properly. While there are various causes of hoarseness, the majority are not severe and typically resolve after a brief period.
Intracapsular tonsillectomy for children
Your child will require a two-week break from school and social activities. Regarding an intracapsular tonsillectomy, the risk of postoperative bleeding is 2 in 1000 children. Tonsils, located at the back of the throat, consist of one on the left and one on the right, playing a role in combating germs and infection. While essential in early childhood, their significance diminishes after age three, and they naturally reduce in size. Even without tonsils, the ability to fight infections remains. Tonsil removal may be considered if their presence becomes more detrimental than beneficial.
MLTB – Micro-laryngo-tracheo-bronchoscopy
MLTB, or micro-laryngo-tracheo-bronchoscopy, is a diagnostic procedure aimed at identifying the underlying causes of your child’s airway symptoms. During MLTB, an endoscope equipped with a light and camera is gently inserted through the mouth to examine the larynx (voicebox), trachea (windpipe), and bronchi (large tubes leading to the lungs). Common indications for MLTB include issues such as noisy breathing, recurrent episodes of croup, and coughing or choking during eating or drinking. This procedure assists the child’s doctor in understanding the nature of the airway and breathing problem, enabling them to formulate an appropriate treatment plan.
Pharyngeal pouch surgery
This condition primarily impacts individuals aged 70 and older, occurring at a rate of one person in 100,000 per year. It exhibits a higher prevalence in males, affecting three males for every two females. Common symptoms include difficulty swallowing, post-meal coughing, regurgitation of food, and susceptibility to chest infections. In about one out of 200 people with a pouch, abnormal cells may be present. Small, asymptomatic pouches can be left untreated, while most interventions for problematic pouches can be conducted through the mouth. In some cases, surgical procedures may necessitate an incision in the neck. It is important to be aware of mediastinitis, a rare but serious infection within the chest, occurring between the heart and lungs.
Snoring and Sleep Apnoea
Several factors contribute significantly to snoring. Being overweight increases the likelihood of snoring, with weight gain worsening existing snoring and weight loss improving it. As individuals age, snoring tends to worsen. Gender also plays a role, with men being three times more likely to snore than women, although women may experience increased snoring after menopause. Alcohol consumption directly affects snoring by relaxing throat muscles, leading to airway collapse—the primary cause of snoring. Additionally, smoking is linked to an increased likelihood of snoring, contributing to the overall exacerbation of this nighttime breathing phenomenon.
Tonsillectomy (taking out your tonsils) because of repeated infections
To be considered for tonsillectomy, you must have a certain number of episodes of tonsillitis, including seven in the first year, five per year over two years, or three infections annually for three years. Following a tonsillectomy, a two-week break from work and social activities is recommended due to the associated pain. Tonsillectomy is known to be painful, and in adults, there is a one in five risk of bleeding after the surgery. Additionally, one in 100 adults may require a second operation to address bleeding, possibly necessitating a blood transfusion. Tonsils, two small glands located at the back of the throat (one on each side), are about the size of a grape. While crucial for fighting infections in childhood, they become less significant with age and typically shrink. However, the body can still effectively combat infections without tonsils.
Tracheomalacia in children
When a child is diagnosed with tracheomalacia, it can understandably be concerning for parents. This e-leaflet provides information about the condition, covering its definition, diagnosis, and treatment. Tracheomalacia, which translates to a ‘weak or soft windpipe,’ arises when the cartilage supporting the windpipe is softer than usual, leading to the potential collapse of part or all of the windpipe. Notably, the soft section of the windpipe is most prone to collapsing during exhalation or coughing. If the primary air passages of the lungs are impacted, the condition is referred to as tracheo-bronchomalacia. For further details and personalized guidance, it is recommended to consult with your child’s paediatric ENT surgeon.
Trans-nasal oesophagoscopy (TNO)
Trans-nasal oesophagoscopy (TNO) is a diagnostic procedure employed to examine the throat, voice box, and esophagus, and occasionally, the surgeon may extend the examination to include the stomach. This involves the insertion of a flexible tube with a camera at the tip, known as an endoscope, through the nostril to visualize these areas. Typically lasting less than ten minutes, the entire appointment may extend up to 30 minutes, especially if additional measures or examinations are needed, potentially prolonging the endoscopy duration.