Oral Biol Res 2024; 48(1): 22-25  https://doi.org/10.21851/obr.48.01.202403.22
The underrated role of cold drinks in post-tonsillectomy care: a pediatric case study
Yei-Jin Kang1 and Seong-Gon Kim2*
1Fellow, Department of Oral and Maxillofacial Surgery, Gangneung-Wonju National University Dental Hospital, Gangneung, Republic of Korea
2Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Republic of Korea
Correspondence to: Seong-Gon Kim, Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Jukheongil 7, Gangneung 25457, Republic of Korea.
Tel: +82-33-640-2468, Fax: +82-33-640-3069, E-mail: kimsg@gwnu.ac.kr
Received: August 9, 2023; Revised: December 20, 2023; Accepted: January 23, 2024; Published online: March 31, 2024.
© Oral Biology Research. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
The benefits of traditional techniques like cold dissection, hot methods, and suturing for reducing post-tonsillectomy complications such as swelling, pain, and bleeding have been established, however, the postoperative advantages of consuming cold drinks remain underappreciated. This case study aims to highlight the beneficial effects of cold-water consumption in post-tonsillectomy care. An 11-year-old girl suffering from mild rhinitis and severe chronic mouth breathing underwent tonsillectomy. Her postoperative care regimen involved standard instructions coupled with daily intake of cold beverages. This approach resulted in the complete healing of the intraoral wound, without necessitating additional painkillers. Histopathological evaluation revealed right tonsillar hyperplasia laden with bacterial colonies and hyperplasia in the left tonsil. The consumption of cold beverages or ice cream post-tonsillectomy is a promising alternative for postoperative care in pediatric patients. It prompts an organized spontaneous healing process at the wound site and helps pain management.
Keywords: Cryotherapy; Pain management; Postoperative care; Tonsillectomy; Wound healing

Postoperative complications are a significant concern in patients undergoing tonsillectomy. Swelling, bleeding, and pain are commonly experienced by patients during the recovery period. Various techniques have been employed to address these complications, including cold dissection, hot techniques, and the use of sutures [1-4].

The use of cold techniques in surgical procedures has long been recognized for their ability to reduce inflammation and swelling. Cold-water consumption may provide a similar therapeutic effect in the postoperative period. Drinking cold water can help constrict blood vessels, thereby reducing bleeding and decreasing the chance of hematoma formation. Additionally, the analgesic effect of cold water can help alleviate post-tonsillectomy pain, providing patients with improved comfort during the recovery process.

While traditional methods such as cold dissection and hot techniques have been extensively studied and implemented, the potential benefits of cold-water consumption in post-tonsillectomy care have not been thoroughly explored. By documenting the outcomes of a specific case regarding the use of cold-water consumption, this report aims to contribute to the medical literature and provide healthcare professionals with further information into this potential postoperative intervention. Further research is needed to validate these findings and establish guidelines for the use of cold-water consumption as part of post-tonsillectomy care.

Case Description

The department of orthodontics referred an 11-year-old girl with mild rhinitis and severe habitual mouth breathing for tonsillectomy. Clinical examination and radiographic assessment revealed enlargement of both palatine tonsils. The surgical procedure involved mask-induced anesthesia, orotracheal intubation, tonsillar dissection via a self-retaining retractor, and sutured using Vicryl (polyglactin 910; Ethicon, Somerville, NJ, USA). Hemostasis was achieved by gauze packing and compression, and bipolar coagulation was used for minor bleeding. The surgical specimen was preserved in formalin for histopathological analysis (Fig. 1).

Fig. 1. (A) Both palatine tonsils were enlarged. (B) Both sides of mucosa were sutured with Vicryl (Ethicon, Somerville, NJ, USA). (C) Removed right palatine tonsil. (D) Removed left palatine tonsil.

The patient was monitored for 3 hours after surgery. In addition to routine postoperative instructions, the intake of cold drinks, such as cold water or ice cream without solids or colorants, was advised once daily. Pain was managed with ketorolac administered every 8 hours. Histopathological examination revealed right tonsillar hyperplasia with bacterial colonies and left tonsillar hyperplasia (Fig. 2).

Fig. 2. Bacterial colony in removed right palatine tonsil (H&E stain).

Consent for the utilization of treatment data for scientific research purposes was obtained from the patientʼs parent.


Despite various approaches to mitigate post-tonsillectomy complications, managing postoperative pain continues to present a challenge [2,4]. In previous studies, the consumption of cold drinks as part of postoperative care [5,6] reduces blood flow in large skin areas [7] and decreases temperature [8]. Thereby we could infer that it would promote an organized spontaneous healing process at the wound site. Specifically, cold drinks can provide deep cooling to the surgical site, thereby reducing postoperative bleeding.

Immediate cooling has historically been a widespread treatment for thermal injuries, offering pain relief, minimizing tissue damage, and improving healing. Given that tonsillectomies often involve electrocautery, causing thermal injury, rapid cooling could potentially reduce injury zones and improve patient outcomes [6].

Tissue cooling has shown positive effects in other transoral procedures, such as third molar extraction, by reducing postoperative pain. Furthermore, in the specific context of tonsillectomies, ice pops have demonstrated a substantial reduction in pain 30–60 minutes after the surgery. In addition, a combination of cold and pain stimuli can reduce the perception of pain [8], and altering local temperatures may decrease muscle spindle sensitivity to stretching, thereby reducing muscular spasms [8]. Moreover, recent studies have highlighted the role of mammalian cold-inducible RNA-binding proteins in promoting wound healing by activating adenosine monophosphate-activated protein kinases. This indicates the potential benefits of cold drink intake for wound healing and pain control after tonsillectomy [9].

As it is not a perfect treatment alone, according to a previous study, postoperative vessel embolization [10] and intraoperative bupivacaine injection [11] are possible measures to reduce postoperative bleeding and pain. Thorough preoperative planning and consideration of those measures are necessary to minimize postoperative complications.

The of limitations of this case presentation stem from its single case study design, which restricts the generalizability of the findings to a larger population. It is important to recognize that the observed effect of cold drinks on post-tonsillectomy care may be specific to this particular patient and influenced by her individual physiological response. The absence of a control group makes it difficult to definitively attribute the improved postoperative outcomes solely to the consumption of cold drinks. Other factors such as the patient’s overall health, age, or healing capacity may have also contributed to her recovery. Furthermore, the reported decrease in pain post-tonsillectomy is subject to the patient’s subjective perception, which can vary significantly among different individuals. Therefore, given the limitations of this single case study, it is not sufficient evidence to modify standard postoperative care practices. More comprehensive research, preferably randomized controlled trials, are needed to validate the potential benefits of cold drink consumption post-tonsillectomy. Additionally, it is challenging to account for all potential confounding variables in a single case study, such as the patient’s overall postoperative care, lifestyle habits, or genetic predispositions, which could have influenced the findings. It is also important to note that the findings of this case study are specific to pediatric patients, and separate investigation is needed to understand the effects of cold drinks on post-tonsillectomy care in adult patients.

In spite of these limitations, this study has many merits. First, this study introduces a potentially effective, non-invasive and cost-effective approach to post-tonsillectomy care in pediatric patients through the daily consumption of cold drinks. If substantiated by larger studies, this could change standard care protocols. Second, the study suggests that cold drinks can aid in pain management post-tonsillectomy, which is often a significant concern in pediatric patients. This non-pharmacological approach could potentially reduce the reliance on analgesics, thereby minimizing potential drug side effects. Third, given that the proposed treatment involves consuming cold beverages or ice cream, it’s likely to have high patient compliance, especially among children. Considering the patient’s young age, the consumption of cold drinks or ice cream is a viable alternative in post-tonsillectomy care.


The histopathological evaluation was performed by Department of Oral and Maxillofacial pathology in Gangneung-Wonju National University of Dental Hospital.


This work was carried out with the support of Department of Oral and Maxillofacial Surgery and Department of Orthodontics in Gangneung-Wonju National University of Dental Hospital.

Conflicts of Interest

The authors declare that they have no competing interests.

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  • Gangneung-Wonju National University of Dental Hospital

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