Ear Pain After Tonsillectomy: Causes and Solutions

Tonsillitis with ear pain?

Hello Doctor, I have been experiencing a long-term sensation of foreign body in my tonsils along with chronic inflammation.
Recently, on the 1st, I underwent surgery to remove both sides of my tonsils.
Before the surgery, there was a white area where the adenoids used to be, which was biopsied and found to be normal.
However, since then, that area has been persistently aching.
I discussed this issue with my attending physician, who suggested that it might be related to the tonsils and that there was only mild inflammation, so no further removal was necessary.

Around February, I suddenly experienced severe pain in my left ear and visited the clinic three times.
The first visit indicated that it was temporomandibular joint inflammation, not a tonsil issue.
The second and third visits suggested that it might be related to chronic tonsil inflammation.
I have also mentioned this to my surgeon, who indicated that it could be related to the tonsils, so I have been enduring the pain along with constant tinnitus and a feeling of fullness in my ear (the doctor examined my ear and said there was no inflammation), attributing it all to the tonsils.
Now, I would like to ask you, Doctor, I had a self-funded cryoablation procedure to remove my tonsils on the 1st, stayed in the hospital for two days post-surgery, and was discharged on the third day without any bleeding issues.
In the initial days, my entire mouth and throat were very painful.
By the 6th or 7th day, the area where my left tonsil and adenoids were chronically inflamed was still very painful, while the pain on the right side had significantly decreased.
However, the left side remained painful, and I also experienced ear pain and persistent tinnitus.
I noticed yellow-green discharge when I spat from my throat, so on the 7th day, I went to the emergency department at the original hospital.
The resident physician examined both sides of my surgical wounds and noted that they looked similar, with the left side being slightly red but not inflamed.
They mentioned that the color of the saliva might be due to wound secretions and contacted my surgeon, who suggested I could either be admitted for pain management or take medication home.
I opted to take pain medication home since I have children.
Today is the 9th, and this morning I noticed some blood in my saliva, with a metallic taste in my throat, but I have not coughed.
I am observing the situation.
As of today, the area around my left adenoids and throat is still very painful, and my ear is also very painful and uncomfortable.
I want to ask you, Doctor, if this pain feels like inflammatory pain, but the doctor says it is not.
I am very concerned that there might be an issue with the wound or something else.
How many more days should I expect to endure this pain? It is truly very painful, and my ear discomfort is significant.
I am unsure what to do now, as I have seen many doctors regarding my tonsil issues, and many have prematurely attributed the problems to my tonsils.
Now that I have had them removed, why am I still experiencing tinnitus, fullness, and pain in my ear? How should I approach medical care and communicate my concerns clearly? I apologize for the lengthy message, and I appreciate your patience in reading it.
Thank you for your response.

Miss Yang, 40~49 year old female. Ask Date: 2021/04/09

Dr. Zheng Jueyi reply Otolaryngology

Hello, it is difficult to determine the causes of tinnitus, ear fullness, and ear pain, as there are many potential reasons for ear pain.
In addition to the possibility that the surgical site from a tonsillectomy has not fully healed, chronic throat inflammation, temporomandibular joint disorders, or other issues may also be contributing factors.
If you notice only blood streaks in your saliva, you can initially monitor the situation.
However, if there is significant bleeding, you should seek medical attention immediately.
If the pain persists, it is advisable to return to the outpatient clinic for further evaluation and treatment by a physician.
Wishing you safety and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/04/09

More Info

After a tonsillectomy, it is not uncommon for patients to experience ear pain, a phenomenon often referred to as referred pain. This occurs because the nerves that supply the throat and tonsils also supply the ears. Therefore, inflammation or irritation in the throat can manifest as pain in the ears. In your case, it seems that you have been experiencing persistent discomfort in your throat and ears following the surgery, which can be concerning.

The pain you are experiencing in your left ear, along with the sensation of ear fullness and tinnitus (ringing in the ears), could be attributed to several factors. First, it is important to consider that after a tonsillectomy, the surrounding tissues, including the adenoids (which are located near the tonsils), can become inflamed or irritated. This inflammation can lead to referred pain in the ear, as the nerves are interconnected.

Additionally, the presence of yellow-green secretions from your throat could indicate some level of infection or inflammation, even if the doctors have not observed any overt signs of infection during examinations. It is also possible that the surgical site is healing, and the pain you feel could be a normal part of the recovery process. However, if the pain persists or worsens, it is essential to follow up with your healthcare provider.

Here are some steps you can take to address your concerns:
1. Follow-Up Appointment: Schedule a follow-up appointment with your ENT specialist. It is crucial to communicate all your symptoms clearly, including the ear pain, the sensation of fullness, and any changes in your throat secretions. Make sure to mention the history of chronic tonsillitis and any previous treatments you have undergone.

2. Pain Management: Continue to manage your pain with over-the-counter pain relievers, as recommended by your doctor. If the pain is severe, your doctor may prescribe stronger pain medication.

3. Hydration and Rest: Ensure you are staying hydrated and getting plenty of rest. This can help your body recover more effectively.

4. Monitor Symptoms: Keep a close eye on your symptoms. If you notice any new symptoms, such as fever, increased swelling, or worsening pain, seek medical attention promptly.

5. Consider a Second Opinion: If your symptoms do not improve or if you feel your concerns are not being adequately addressed, consider seeking a second opinion from another ENT specialist. They may provide additional insights or recommend further diagnostic tests, such as imaging studies, to rule out any underlying issues.

6. Ear Examination: Since you are experiencing significant ear pain, it may be beneficial to have a thorough examination of your ears. Sometimes, conditions like Eustachian tube dysfunction can occur after surgery, leading to pressure and pain in the ears.

In conclusion, while ear pain after a tonsillectomy can be a common occurrence due to referred pain, it is essential to ensure that there are no complications or underlying issues. Persistent pain, especially if accompanied by other symptoms, warrants further investigation. Open communication with your healthcare provider is key to finding a resolution to your discomfort.

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