Bechara Y. Ghorayeb, MD, PA
Otolaryngology-Head & Neck Surgery                                                          Phone: 713 464 2614
1140 Business Center Drive, Suite 560
Houston, TX 77043                            www.ghorayeb.com


T & A Informed Consent
Removal of tonsils and/or adenoids is one of the most frequently performed throat operations. It has proven to be a safe, effective surgical method to resolve breathing obstruction, throat infections and manage recurrent childhood ear disease. Pain following surgery is an unpleasant side effect, which can be reasonably controlled with medication. It is similar to the pain patients have experienced with throat infections, but often is also felt in the ears after surgery. There are also some risks associated with removal of tonsils and/or adenoids. Post operative bleeding occurs in about 2% of cases, most often immediate, although it can occur at any time during the first 2 weeks after surgery. Treatment of bleeding is usually an outpatient procedure, but sometimes requires control in the operating room under general anesthesia. In rare cases, a blood transfusion may be recommended. Because swallowing is painful after surgery, there may be poor oral intake of fluids. If this cannot be corrected at home, the patient may be admitted to the hospital for IV fluid replacement.  Very rarely, disturbances in the sense of taste or loss of taste in one side of the tongue may take place.  Anesthetic complications are known to exist; they are quite uncommon, however, since patients are usually young and healthy.



I/We have been given an opportunity to ask questions about my condition, alternative forms of treatment, risks of nontreatment, the procedures to be used, and the risks and hazards involved, and I/we have sufficient information to give this informed consent. I/We certify this form has been fully explained to me/us, and I/we understand its contents. I/We understand every effort will be made to provide a positive outcome, but there are no guarantees.


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Patient / Legal Guardian
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Witness

Date:___________________________          Time:___________________________


www.ghorayeb.com
PICTURES OF TONSILLITIS
PICTURES OF ADENOIDS