Home Care after Sleep Surgery-Hyoid Suspension, Lingual Tonsillectomy (LT), Tongue Base Reduction

The above surgeries are all performed on patients to help relieve or lessen the symptoms of sleep apnea. All address the base of tongue (the portion farthest from the front).

General Information

You may lack energy for several days, and may also be restless at night. This will improve over the next 10 to 14 days. It is quite common to feel progressively worse during the first five to six days after surgery. You may also become constipated during this time for three reasons: you will not be eating a regular diet, you will be taking pain medications, and you may be less active.

Wound Care

Lingual Tonsillectomy (LT) and Tongue Base Reduction surgery are performed within the mouth, and no planned external incisions are made. You may feel suture within your mouth. This is normal and will dissolve over the next two weeks. No specific wound care is necessary for these procedures. If you have had a hyoid suspension, you will have one or two small external incisions along the front of your neck. These will be closed with dissolvable stitches. If a steri-strip is in place (a small white piece of tape), you will leave this in place until follow-up and no wound care is necessary. If you can see the stitches (no steri-strip in place), you will be instructed to place a thin layer of antibiotic ointment along the stitch line twice a day until healed.

Diet

It is important for you to drink plenty of fluids after surgery. Drink every hour while awake. A soft diet is recommended for the first 14 days (anything that you may eat without teeth constitutes as a soft diet). Avoid hot liquids/solids. It is alright if you don’t feel like eating much, as long as you drink lots of fluids. Signs that you need to drink more are when the urine is darker in color (urine should be pale yellow). A high fever that persists may also be a sign that you are not taking in enough fluids. As your appetite improves, solid foods and chewing should be strongly encouraged. There are no limits on the sort of foods you can eat. You cannot damage the throat by eating any particular type of food.

CPAP

If you have CPAP at home, it is recommended that you use it at the previously prescribed settings until another sleep study is performed. It can help decrease swelling, as well as prevent obstructive apnea in the post-operative period.

Activity

You should rest at home for the first 48 hours. Activity may increase as strength returns. Generally patients return to work approximately 10-14 days. All heavy lifting, exercise or other vigorous activity should be avoided for 14 days after surgery.

Pain

Throat and ear pain (referred) can be severe after these surgeries. Use pain medications as needed and as directed. However, be aware that prescription pain medication makes sleep apnea worse. Therefore, you will be encouraged to use over the counter medications primarily, with prescription meds to be used for severe pain only.

Bad Breath/Snoring

Bad breath is very common due to the healing in the back of the throat. You may gargle with a mild salt water solution to improve the bad breath (1/2 teaspoon table salt to eight oz. of warm tap water) and/or chew gum. Most people breathe through the mouth and snore during the recovery period due to swelling. This may last between 2-3 weeks. It may be helped by propping up with pillows. Turning on a humidifier at bedtime may lessen throat dryness caused by mouth breathing. Avoid over-the-counter mouthwashes (Cepacol, Scope, Listerine, etc.) as they tend to dry the throat and cause discomfort.

Bleeding

There should be NO bleeding from the nose or mouth. If you see any bleeding at all, sit upright and phone your doctor immediately. Swishing the mouth out with cold ice water may help stop the bleeding (rinse and spit over and over). In tonsillectomy, between 5 and 10 days after surgery, the white or grayish membrane (soft scab) breaks off in the back of the throat. A small amount of bloody mucus may be spit up. If this continues after a few minutes, please call the doctor. If you are unable to reach the doctor quickly, please go to the emergency room.

Fever

It is normal to have a slight fever (99.0° to 101.0°) for the first few days following surgery. Good fluid intake and Tylenol will help keep the fever down. If the fever is over 101 degrees contact your doctor.

Nausea/Vomiting

It is not unusual to feel sick the day following sleep surgery. You may even be given a prescription for nausea. If vomiting persists into late evening you may want to contact the doctor for a medication to feel better. If still vomiting the day after surgery, you need to notify the doctor.

Medications

Take the following medications as prescribed to you:

• Narcotic pain medication: Norco or Lortab (Hydrocodone/Acetaminophen) are generally prescribed to adults. This is a Narcotic medication to be used every 4-6 hours as needed for
  severe pain only. Narcotic pain medication can slow breathing and worsen sleep apnea. Use only if pain is not controlled by other measures. After the first few days, you should attempt to use OTC Tylenol in place of this medication. Do not exceed 4g of Tylenol in 24 hours.
• Antibiotic: A penicillin antibiotic such as Amoxicillin is prescribed to be used a few days after surgery. If you are pen-allergic, you will receive a different antibiotic.
• Carafate: This medication is prescribed in liquid form. It is used to coat your throat to provide a soothing effect. Take as prescribed. If Carafate is not covered by insurance, we can prescribe a magic mouthwash solution.
• Prednisone: A steroid taper is often prescribed to help with post-operative pain. Take as prescribed.

Call your Doctor or go to the Emergency Room immediately with any of the following

• Difficulty breathing
• Bleeding
• Sudden increase or large amount of neck swelling

For Questions or Emergency Care:
Call the office at 601-984-5160. You may need to speak with the doctor on-call.

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