Post-Tonsillectomy Throat Discomfort and Concerns

Oral issues

Hello Doctor, I apologize for bothering you again.
I would like to ask for your help regarding my condition.
It has been four months since I underwent a bilateral tonsillectomy, and during this time, I have been experiencing discomfort, particularly in the left palatoglossal arch, palatopharyngeal arch, and deep in the throat near the base of the tongue.
For the past few months, I have been returning for monthly follow-ups, and the doctors have assured me that the wounds are healing well.
However, over a month ago, the sensation of a foreign body in my throat became significantly worse, accompanied by discomfort and pain.
Even when I am not eating, it feels like something is stuck in my throat, and I have increased salivation that sometimes causes sharp pain.
During my previous visits, I mentioned this to my doctor, who suggested that it might be due to acid reflux.
Now, a month later, I returned for another check-up and informed the doctor that my endoscopy showed no significant issues, and the acid reflux was mild, which should not cause severe sensations of a foreign body in my throat.
The night before my appointment, I attempted to take a photo to show the doctor exactly where I felt discomfort, and I accidentally discovered a lump on the right side of my throat that protrudes when I exert pressure with my tongue.
There was also a white spot on it, which I couldn't reach with a cotton swab.
During today’s visit, the doctor examined me with a tongue depressor and indicated that it was the palatine tonsil at the back of my tongue.
He mentioned that if I needed surgery, it could be complicated, and he was concerned that the sensation of a foreign body might persist post-surgery, thus not resolving the issue.
He noted that he had seen the lump during an endoscopy over a month ago but did not inform me at that time.
I had previously felt around the base of my tongue and did not notice this lump; I only felt a hard mass on the posterior pharyngeal wall.
I also asked the doctor about the nature of the lump, and he stated that it is common for everyone to have such findings.
However, I pointed out that the lump only protrudes when I exert pressure on the right side.
I inquired about the white object, and the doctor suggested it might be food debris that could disappear over time.
I requested that he perform another endoscopy for a clearer examination, but he was reluctant to do so.
I expressed my distress over the persistent sensation of a foreign body and the pain, which is causing me significant anxiety about what the underlying issue might be.
The doctor prescribed medication to help alleviate my anxiety, but I am hesitant to stop investigating the source of my discomfort, especially since the problem has not resolved since the surgery, and now there is a lump.
Given the current pandemic situation, I am unsure how to pursue further examinations.
I have an image from before the surgery where a biopsy was taken from that area, and I still experience pain there (between the palatoglossal arch and palatopharyngeal arch, where the tonsils used to be).
However, since the surgery, I cannot see inside that area anymore, but I continue to have a sharp pain and the sensation of a foreign body, sometimes feeling like there is something at the back of my tongue, and other times feeling like it is in the posterior pharyngeal wall, which is driving me to the brink of despair.
Could you please help me analyze whether my issue is related to the floor of the mouth? Additionally, if the sensation of a foreign body in the throat is not related to acid reflux, what should I be cautious about? I am genuinely worried that if I leave these discomforts and pains unaddressed, I might miss the optimal treatment window.
My child is still very young, and I would like to know if the lump on the lingual tonsil could be something serious (is it located near the back of the tongue close to the pharyngeal wall?).
What examinations can I undergo to ensure that I can address these discomforts with peace of mind? Thank you very much; I am willing to pay out of pocket for clarity to ensure there are no undetected lesions.

Miss Lin, 40~49 year old female. Ask Date: 2021/07/26

Dr. Zheng Jueyi reply Otolaryngology

Hello, if the clinical physician has examined you and found no obvious issues, you can generally feel reassured.
However, if you still have concerns about other abnormalities, you may consider opting for a self-paid health check, including an MRI of the head and neck and a whole-body PET scan.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/07/26

More Info

Post-tonsillectomy throat discomfort can be a challenging experience, especially when symptoms persist long after the surgery. Your concerns about the sensation of a foreign body in your throat, pain, and the recent discovery of a lump are valid and warrant careful consideration.

Firstly, it’s important to understand that after a tonsillectomy, the throat undergoes significant changes. The removal of the tonsils can lead to alterations in the anatomy of the throat, which may cause sensations that feel unusual or uncomfortable. The areas you mentioned, such as the palatoglossal arch and the base of the tongue, can be particularly sensitive after surgery. The sensation of a lump or foreign body can be exacerbated by anxiety, which is common in patients experiencing ongoing discomfort.

The fact that your doctor has indicated that the surgical site appears to be healing well is reassuring. However, the persistent discomfort and the new lump you’ve noticed raise important questions. It’s not uncommon for patients to experience post-operative symptoms such as pain, swelling, or even the sensation of something being stuck in the throat for an extended period. This can sometimes be related to muscle tension or irritation in the throat area, especially if you are experiencing gastroesophageal reflux (GERD), which can contribute to throat discomfort.

Regarding the lump you discovered, it’s crucial to have a thorough evaluation. While your doctor suggested it could be food debris or a normal anatomical variation, your insistence on further investigation is understandable. If your doctor is hesitant to perform another endoscopy, you might consider seeking a second opinion from an ear, nose, and throat (ENT) specialist who can provide a more detailed examination and possibly perform imaging studies if necessary.

In terms of managing your symptoms, there are several approaches you can consider:
1. Reflux Management: If gastroesophageal reflux is contributing to your throat discomfort, lifestyle modifications such as avoiding spicy or acidic foods, eating smaller meals, and not lying down immediately after eating can help. Over-the-counter antacids or proton pump inhibitors may also be beneficial, but you should discuss these options with your doctor.

2. Hydration and Humidification: Keeping your throat moist can alleviate some discomfort. Drinking plenty of water and using a humidifier at home can help soothe irritation.

3. Pain Management: If you are experiencing significant pain, over-the-counter pain relievers such as acetaminophen or ibuprofen may provide relief. However, consult your healthcare provider before starting any new medication.

4. Anxiety Management: Given that anxiety can exacerbate the perception of pain and discomfort, consider discussing this aspect with your healthcare provider. Techniques such as mindfulness, relaxation exercises, or even therapy may help you cope with the emotional toll of your symptoms.

5. Follow-Up Care: Continue to advocate for your health. If your symptoms do not improve or worsen, insist on further evaluation. You have the right to seek a second opinion or request additional tests to ensure that any underlying issues are addressed.

In conclusion, while post-tonsillectomy discomfort can be frustrating and concerning, it’s essential to approach the situation with a comprehensive plan. Keep communication open with your healthcare providers, and don’t hesitate to seek further evaluations if you feel your concerns are not being adequately addressed. Your health and peace of mind are paramount, and taking proactive steps can lead to a better understanding of your symptoms and appropriate management.

Similar Q&A

Understanding Tonsillectomy: What to Expect and Common Concerns

Hello Doctor, I visited the clinic today and the doctor recommended that I have my tonsils removed, which I agreed to. However, I forgot to ask the following questions, and I would appreciate your answers. My condition involves recurrent tonsillitis and frequent tonsil stones. ...

Dr. Li Jiaxuan reply Otolaryngology
1. The majority of the palatine tonsils will be excised. 2. Postoperatively, there will be significant pain. For 1-2 weeks, a softer diet is recommended. Initially, due to the repositioning of the uvula and surrounding mucosa (the M-shaped area at the back of the mouth), eating m...

Post-Tonsillectomy Concerns: Pain and Recovery Insights

Hello, doctor. I was hospitalized in May of this year due to tonsillitis with purulent infection and high fever, and I received antibiotic treatment. Afterward, I switched to oral Augmentin 1g twice a day, but every time I stopped the medication, the symptoms would recur. This si...

Dr. Zheng Jueyi reply Otolaryngology
Hello: If there is no obvious fever and the pain is gradually improving, it is generally considered a normal phenomenon. However, if the pain continues to worsen, it is advisable to return for an earlier check-up. Before the wound is completely healed, it is recommended to rinse ...

Post-Surgery Complications: Managing Pain and Discharge Concerns After Tonsillectomy

Hello Doctor, I previously discussed my issues in detail. I had my bilateral tonsils removed on the 1st and was discharged on the 3rd. On the 7th, due to severe pain, I went to the emergency department of the surgery hospital, where the resident physician examined me and stated t...

Dr. Zheng Jueyi reply Otolaryngology
Hello, if you have yellow-green discharge, you may first visit a nearby otolaryngology clinic to check for other infection issues. If there is no improvement or if further evaluation is needed, you can ask the clinic physician for a referral to a nearby hospital for further manag...

Post-Tonsillectomy Recovery: Common Symptoms and Timeline Explained

Hello Doctor, three weeks ago I underwent a tonsillectomy, and my wound has healed about 80% (as mentioned by the doctor during my follow-up). However, I am still experiencing symptoms of throat itchiness and coughing. I feel slight pain when yawning, and my voice sounds a bit ho...

Dr. Zheng Jueyi reply Otolaryngology
Hello: If there is no obvious pain or bleeding, the wound will generally heal gradually, with the speed of recovery varying from person to person. Increasing protein intake can help promote healing. Wishing you safety and good health. Sincerely, Dr. Cheng Jue-Yi, Director of the ...