Tips from Dr. Pedro Machava


An adenotonsillectomy is the removal of tonsils and adenoids in the same surgical procedure and it is performed under general anesthesia.

Indications for an adenoamygdalectomy:

  • 3 or more tonsil infections or adenoids per year;
  • Tonsillar enlargement causing occlusal or changes adversely affecting the orofacial growth, documented by an orthodontist;
  • Hypertrophy causing upper airway obstruction, severe dysphagia, sleep disorders or cardiovascular complications;
  • Peritonsillar abscess unresponsive to medical treatment and drainage;
  • Bad taste or breath due to chronic tonsillitis that is unresponsive to medical treatment;
  • Suspected neoplasia in unilateral enlarged tonsils;
  • Suppurative otitis media with effusion or recurrent..
  • From the medical evaluation, the indication is individualized and depends on the persistence of symptoms such as mouth breathing, snoring, obstructive sleep apnea, recurrent otitis, disturbances in the flow of food, among others, when related to the increased volume of adenoid.


  • Some contraindications are related to general anesthesia, or if the patient has a serious disease in which the risks to anesthesia are great. The procedure also tend to be avoided in very young children, in the presence of airway infection, respiratory diseases uncontrolled problems with certain sites, for example, disorders of the soft palate and cleft palate. Remember the inherent limitations of patients with neuromuscular diseases and blood coagulation disorders.


After an adenotonsillectomy operation, please care for the following:


  • 4th hour - Liquid feed, cold or natural (syrups, milk, gelatin, ice cream, not acidic fruit juices);
  • 4th day - Cold or natural food (porridge, fruit, cooked vegetables, dairy products, beat soup, shredded beef);
  • 6th day - Paste foods (well cooked pasta and boiled rice, soft meats);

NOTE: Do not eat toasted or any food that might hurt,very hard or hot foods ,and large amounts of food

Frequent occurrences:

  • Sore throat and ears;
  • Bad breath;
  • Fever up to 38°C (until the 2nd day);
  • White patches in the throat;
  • Abdominal bloating.

Notify the doctor if:

  • Hemorrhage;
  • High fever (more than 38°C);
  • Fever after the 3rd day ;
  • Doubts and concerns.


Environmental care is important for the treatment of allergic rhinitis in children.

  • Mattresses, preferably foam / rubber should be coated with plastic material;
  • Do not use woolen blankets or fluffy;
  • Avoid curtains, carpets and rugs;
  • Cleaning should be done with damp cloth;
  • Do not use brooms, dry rags, brushes or mops;
  • The room should be well ventilated and the sun should come during the day;
  • When the cold season is approaching, winter clothes should be washed and / or brushed and exposed to the sun. Never wear clothing that was kept too long in the drawer or cabinet without air them;;
  • Parents or the nanny should not wear wool coats or plush, when a child is sitting on their laps;
  • Avoid animals inside the house;
  • Avoid breathing dust or air from closed residences;
  • Avoid spray insecticides, electric insecticides, perfumes, powders, paints and other strong smelling substances;
  • Cockroaches (large and small) are a big source of allergies. Regularly fumigate your residence or use a bait system ;
  • Avoid contact with cigarette smoke.


Knowing how to clean a children's nose is very important.
Proper nasal cleansing can prevent respiratory diseases ,and help the treatment of rhinitis and sinusitis.
A good guidance from your doctor is the first step to start a proper nasal cleaning.

Removing secretions:

  • Children (or infants), or those who do not know how to clean their nose: should gently use a cotton swab to remove secretions from the outer part of the nostrils.Never deeply introduce the stem;
  • Older children: Ask your child to gently blow your nose. In case of nasal obstruction, do not blow your nose hard.

Washing a child's nose:

  • Promote a peaceful environment;;
  • Explain to your child the importance of cleaning the nose and how it will be done;
  • Warm saline (you can rub the glassed saline solution between the hands or put it under the armpit to heat);
  • When heating saline with bath water, evaluate the temperature on the back of the hand;

Dropper Syringe:

  • Gently tilt back the head of the child;
  • Do not enter the dropper syringe into the serum container, use a small cup;
  • Inject the prescribed dosage of serum to promote cleaning of the nasal cavity.

Nasal spray :

  • Sit the child's chin down;The spray used that sited position, achieves the most posterior region of the nose.

Saline care:

  • Store in refrigerator;
  • Renew every 2 or 3 days.

WARNING: The habit of blowing your nose can strongly promote the sending of secretions to the paranasal sinuses or the ears.


The document below is made up of general information, and should not be considered as advice to any child specifically. Each patient is a different case and requires an individualized medical care.

The information in this document is useful to parents and family members to understand the health problems of their children, but is no substitution for medical consultations.

Click the link to download the document: Quality of life.


Badly ingested food can kill children;
statistics shows that 17,000 children who chock on food, 155 will die.

Stop and think:

  • Children can drown or choke with the food if they are doing one of the actives: walking, running, lying, crying or laughing;
  • Try to avoid hard foods like raw carrots and celery, as well as large and soft products such as marshmallows;
  • Cook, grate and cut food into very small pieces to prevent them from obstructing the respiratory ducts.