Tonsillitis can be a recurrent condition, occurring more than once a year. In adults, tonsillitis can be very painful and is associated with fever, swollen glands and difficulty in swallowing. Generally lasting for at least 5 days, it can also be triggered by glandular fever in teenagers.
Tonsillitis is an inflammation of the tonsils – two small glands that sit on either side of the throat – normally caused by a viral or, less commonly, a bacterial infection.
Laser vapourisation tonsillectomy usually involves minimal blood loss and can be relatively safely performed in patients who are completely against possible blood transfusion (e.g. Jehovah’s Witness patients). During this operation, there was no significant active bleeding. Specifically, we can see the back wall of the throat has no blood on it at all.
The intracapsular removal of approximately 95% of the tonsil tissue means that this procedure is effective. Also, since the capsule is intact, it is safer than dissection (bipolar, etc.) tonsillectomy, where the capsule is completely removed, as the major vessels to the side of the tonsils (peritonsillar vein, superior and inferior tonsillar arteries, ascending pharyngeal artery) are not exposed.
Laser tonsillectomy for adults – intracapsular technique
In adults, we recommend the intra-capsular flash scanned Carbon Dioxide laser procedure, either under local anaesthetic (tonsillotomy) or general anaesthetic (tonsillectomy).
Laser tonsillectomy under general anaesthetic is a same-day procedure where patients are kept in the hospital for observation for 6 hours post-op. This technique removes around 95% of the tonsils in one attempt, so the need for a second procedure is much lower. Time off work is kept to a minimum, generally, it is 48 hours after surgery. There can be some pain and discomfort which can last around 7 days post-op.
This dramatic pain reduction is due to the tonsil capsule kept intact – meaning that the throat muscle and the blood vessels around the tonsil are not exposed. The flash scanned Carbon Dioxide laser is the best instrument we know to do this, as it is quick and bloodless.
The only downside of this technique is that small remnant of tonsil tissue is sometimes left behind. These may need further surgery, although it is rare that this is required (1:50 cases). All our patients go home on the day of surgery, after 6 hours.
Ideally, surgery is performed on a Friday, so the weekend is spent recovering, and Monday back to normal.
Even more painful than tonsillitis, quinsy 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. In acute cases, treatment is by draining the pus and giving intravenous fluids and antibiotics. Hospital admission for a few days is required.
Surgical treatment of quinsy
We recommend a general anaesthetic and an intracapsular laser vapourisation tonsillectomy, in which the tonsil is vapourised using the flash scanned Carbon Dioxide laser. Vapourisation is extended into the abscess cavity to exteriorise so that repeated infections cannot occur.
Contact Our Tonsillitis & Quinsy Experts
Our experts at London ENT Unit have many years of experience in dealing with tonsillitis and are able to perform advanced procedures such as a tonsillotomy to ensure relief from any pain or discomfort that you may be experiencing. For any questions or to book an appointment, we recommending contact our ENT team by calling 020 7078 3841 or emailing us at [email protected].