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Tonsillitis

Bad sore throats - true tonsillitis in adults is a very painful condition, often leading to the need to take time off work or studies to recover. It generally lasts for at least 5 days and can be triggered by glandular fever in teenagers. In children, it is associated with repeated upper respiratory tract infections, large adenoids, glue ear (hearing loss), ear infections. Tonsillitis can also be linked to other diseases such as psoriasis, bowel problems, joint aches, lethargy and possibly ME. Treatment: In adults, we recommend general anaesthetic inside-out laser vapourisation tonsillectomy, where the tonsil is vapourised using the scanned carbon dioxide laser, sometimes using a microscope and micromanipulator. In our experience of over 400 cases treated there has been a bleeding rate of less than one percent, 70 percent of patients did not need to change their diet postop, since pain levels were low, and lasted for around 7 days. This is a daycase procedure, an inpatient stay of 6 hours is recommended. We feel that it is much less painful than dissection tonsillectomy, which is the commonly used technique, little changed over 40 years. Because a small amount of tonsil tissue is left behind, there is a slightly higher revision rate a year after surgery, when compared to dissection tonsillectomy. Treatment: In children, bipolar, non laser dissection is used, since young children generally have little problem with dissection techniques. Children are kept in overnight to minimise risks post-operatively. Local anaesthetic is used after the operation before the child has awoken, in order to minimize postoperative pain. More Information: For more detail, including local anaesthetic tonsil reduction, please click on the conditions treated, tonsil problems, then laser tonsillectomy menu-tab above. Prices: Start at £800 inclusive.

Quinsy

Even more painful than tonsillitis, this is an abscess on the inside of the tonsil, causing spasm of the jaw muscles, ear pain and almost complete inability to swallow. It is usually on one side only, and is often triggered by tonsillitis. Treatment: We recommend general anaesthetic inside-out laser vapourisation tonsillectomy, where the tonsil is vapourised using the scanned carbon dioxide laser, sometimes using a microscope and micromanipulator. Vapourisation is extended into the abscess cavity to exteriorise it so that repeated infections cannot occur.

Picture shows a left sided quinsy, the numbers mark the point of cute pus aspiration when drained.

 

Tonsilloliths

Smelly white lumps produced from the back of the mouth, they have a cheesy consistency and are produced from cracks and crevices in the tonsils. They can be associated with bad breath and recurrent sore throats, or a persistantly sore throat - chronic tonsillitis. Treatment: Local anaesthetic spray to numb the surface of the tonsil, followed by laser vapourisation. Approximately 50% of the tonsil on each side can be removed using this technique, which takes only a few minutes. If it is performed on 2 or 3 occasions a significant (90%) removal can be acheived, similar to that of other techniques, and this can be effective in treating tonsillitis as well.

 

Tonsil cancer

A tonsil which is enlarged on one side, painful, sometimes with ear pain, bleeding and swallowing problems, might be cancerous and needs to be looked at urgently. Initially a biopsy and a CT scan are the minimum requirement, to be followed by definitive treatment, which could be chemo-radiotherapy, radical surgery, laser resection or photodynamic therapy.

To view pricing information for this procedure, click here.

If you are interested in the technical information relating to this condition and its treatment by laser, click here to be redirected to the "doctor's version" of this page.