Skip to main content

Featured post

Ear cartilage meatoplasty

  Ear cartilage meatoplasty (conchal cartilage reduction) for external ear canal stenosis — an operation to widen the entrance (outer/cartilaginous part) of the ear canal by reshaping/removing the obstructing conchal cartilage and associated soft tissue, so the canal stays open and can ventilate, drain, and be cleaned.  Why is this being recommended? Your ear canal is narrowed because the conchal cartilage (the bowl-shaped cartilage at the ear opening) is bulky or positioned in a way that crowds the canal entrance. This can lead to a cycle of wax trapping, recurrent otitis externa/inflammation, discharge, blocked hearing, difficulty examining the eardrum , and repeated need for microsuction. Meatoplasty aims to restore a stable, self-cleaning canal opening and reduce recurrent problems.  What benefit can you reasonably expect? The intended benefits are: easier ear toilet/cleaning, fewer blockages and infections, improved access for drops and examination, and (i...

Tonsillectomy




What do tonsil and adenoid do in the body?

In our body, we have lumps of tissue which are related to our immune system called lymph nodes. In our throat and back of the nose, these tissues form a ring called Waldeyer's ring. Tonsil and adenoid form part of this ring and have large clefts which increase the surface area of these tissues and help fight infections and forming our immune bank in the early years of our life. These soldiers or antibodies fight against infection. Tonsils can become enlarged from the age of two and can give symptoms of snoring and sleep apnea or tonsillitis if infected. Enlarged adenoids can give symptoms of nasal obstruction, sinusitis and mouth breathing as they are present at the back of the nose with glue ear and recurrent ear infections. 

What is tonsillectomy and adenoidectomy?


Tonsillectomy is a procedure to remove tonsils if they are infected, cause sleep apnea or get frequent stones. It can be done by cold steel instruments,  diathermy, coblation or LASER.

Adenoidectomy is the procedure to reduce the size of adenoids as adenoids are attached to neck muscles and skull base. Adenoids can be managed by curettage, suction diathermy or coblation.


In some cases, they can done together to be called adenotonsillectomy. In some cases, if indicated this can be combined with grommet insertion in ears. 



Will tonsillectomy affect the singing voice?


Tonsillectomy is a procedure to remove tonsils if they are infected or have tonsil stones leading to bad breath or enlarged leading to sleep apnea or suspicion of cancer. If you are a professional singer, then it is crucial to understand how any procedure on your throat can affect your singing tone.
Tonsil sits on your pharyngeal muscles, and tonsillectomy can lead to scarring of these muscles. If you have large tonsils after tonsillectomy suddenly you will have more volume in your throat and can affect your vocal resonance. You may need support from a speech therapist and voice trainer to retrain. Anaesthetist and surgeon have to be aware of your profession. The surgeon can use low thermal damage techniques for tonsillectomy. 

Will tonsillectomy help sleep apnea?


Sleep apnea or upper airway resistance can be due to multilevel obstruction. Enlarged tonsil can cause symptoms of snoring and high upper airway pressures. Sleep apnea treatment includes using CPAP. It is believed using CPAP in children can lead to facial deformity. A recent systemic review of the literature shows strong evidence that tonsillectomy for enlarged tonsils in children improves sleep apnea. Though tonsillectomy in adults on its own is not so effective. Tonsillectomy along with other palatal surgery tend to improve sleep apnea score.


Will tonsillectomy cure tonsil stones?


We all have tiny crevices on the tonsil surface. These crevices help increase the surface area of tonsil so that more bacteria can be caught. Sometimes these crevices catch food debris which can get infected with bacteria. All this can lead to bad smell (halitosis), stone formation (tonsillolith) and/ or frequent tonsillitis. First line treatment of frequent tonsil stone formation is maintaining good oral hygiene by gargling after every meal, brushing your teeth, manually removing or irrigating tonsil tone out. Make sure not to damage throat mucosa to bleed. If this does not work then discussing with ENT surgeon to have tonsils out or resurfaced are a treatment option. Use of coblation tonsillectomy helps to relieve symptoms, and it is a less painful and minimally invasive way.

What if I decide my child not to have a tonsillectomy?

Tonsillectomy is recommended if a child is having frequent tonsillitis and it is affecting the child's school and education. Rate of having tonsillitis will gradually go down over the next few years.
While the child is awaiting the rate of tonsillitis to go down the risk are

Febrile convulsions- this is a child can have fits due to high temperature.
Quinsy- this is abscess formation behind the tonsil which may need drainage and hospital admission for antibiotics.
Reto/ Para pharyngeal abscess- if the abscess and infection spread into the neck. This will need drainage, sometimes in neck and antibiotics.

What is involved in a tonsillectomy operation?

On the day of surgery, you will arrive at the ward. The nurse will show you the allocated room, check the paperwork ( name and operation they are having) and that the child is fasting for at least six hours. A child can have clear liquid for at least two hours before surgery.
The anaesthetist will check if the child has any medical illness, allergies and will discuss any possible anaesthetic complications.
The surgeon will check the consent form and answer any final questions you have before surgery.
You will be able to accompany the child to the anaesthetic room and once the child has full general anaesthesia you will come back to the waiting room.
The actual surgery takes 30mins to 45min excluding anaesthetic time. Once the tonsillectomy surgery is over your child will be transferred to the recovery room. After observation in the recovery, your child will be able to come back to the room. Your child should be able to go home the same day or the next day once they are eating properly. Follow up appointment and post-op instructions for eating and medications are given before you leave the hospital.

Mr Gaurav Kumar 
Ear Nose Throat Consultant
To Book an appointment https://entsurgeonclinic.co.uk/ 
07494914140 
Disclaimer: For general information only, always seek medical advice from your treating consultant. 
https://www.entsurgeon-london.co.uk/

Popular Post

Boil in the Ear canal can be very painful...

How do I know I have boil in the ear canal? The ear canal is lined by skin up to the eardrum. Skin in the outer third of the ear canal has hair follicles. Hair follicles can get infected with bacteria and can form boil or furunculosis. It is challenging to look in our own ear canal. You can only feel a bump in the ear canal entrance which is tender to touch. Why is so painful when we have boil in the ear? Ear canal skin is very tightly attached to underlying cartilage. So any swelling in the skin stretches it and makes it very sore to touch. How do we get boil in the ear canal?  Most common causes of boil in the canal is dryness of the skin and trauma. Dry skin leads to cracks and these cracks can get infected. People who use dry earbuds, fingers, towel edges or pens and traumatise ear canal skin, which can get infected with bacteria. How do I release the temptation of using earbuds? Some people can get very dry skin due to sensitivity to soup, shampoo o...

Bleeding From Ears

  Why is my Q-tip bleeding from my ear?   It can be alarming if you've ever noticed blood on your Q-tip after cleaning your ears. Here are a few reasons why this might happen:   🚫 Avoid Inserting Q-tips Too Deep: The most common cause of bleeding is inserting Q-tips too far into the ear canal. This can lead to irritation, scratches, or even damage to the delicate ear tissues.   🩹 Ear Injuries or Scratches: Vigorous or improper cleaning can cause small injuries or scratches inside the ear canal. These injuries may result in bleeding when you use a Q-tip.   🩸 Ear Infections: Infections like otitis externa or swimmer's ear can make the ear canal more sensitive. Cleaning during an active infection can cause bleeding.   🔄 Wax Impaction: Excessive earwax can cause blockages, leading to a feeling of fullness and impaired hearing. Attempting to clean it out with a Q-tip may cause bleeding, especially if the wax is impacted.   👂 What to Do...

After your Epley manoeuvre — patient information leaflet

  What this leaflet tells you This leaflet explains what to expect after the Epley (canalith repositioning) manoeuvre for posterior-canal BPPV, what you should and shouldn’t do, and when to seek help.   1. Quick summary — what the Epley did The manoeuvre moves tiny particles (otoconia) out of the balance canal of your inner ear and back into a place where they don’t cause spinning (vertigo). Most people feel much better after one or a few treatments. However BPPV can come back (recurrence is common).   2. How you may feel immediately afterwards You may feel dizzy or off-balance for a few minutes to a few hours; nausea is possible.   Some people feel better straightaway; others get gradual improvement over days.   Rarely ,you may have brief recurrences of vertigo — this does not always mean the manoeuvre failed.   3. Activity and posture — what the evidence says Good news: High-quality studies and recent guidelines show that strict he...

Superior Canal Dehiscence Syndrome (SCDS)

🔍 Unlocking the Mystery of Superior Canal Dehiscence Syndrome (SCDS) 🌀✨ It's a rare condition that affects the inner ear, and here's the lowdown:   Cause: SCDS occurs when one of the bony canals in the inner ear, particularly the uppermost semicircular canal, doesn't close or thicken properly during fetal development.   Symptoms:   Hearing Loss: It's a common symptom of SCDS. Sound Distortion: Ever feel like sounds aren't quite right? That could be SCDS at play. Balance Problems: SCDS can throw your balance off, making you feel unsteady. Autophony: Imagine hearing your own heartbeat or breathing louder than usual. That's autophony. World Tumbling Sensation: Loud noises or pressure changes might make you feel like the world is spinning. Diagnosis and Treatment:   CT Scans: A specialist might use these to spot SCDS, but other tests are crucial too. Hearing Tests: Essential for accurate diagnosis. Treatment: Surgery may be necessary for severe symptoms. ...

“Where Are Your Tonsils? Your Health’s First Line of Defence!”

  Where Are Your Tonsils Located?   Learn About Their Position and Importance for Your Health Have you ever wondered where your tonsils are and why their location is significant for your health? Let's explore the fascinating world of tonsils and understand their crucial role in your body's defence system. What Are Tonsils? Tonsils are two oval-shaped masses of lymphoid tissue located at the back of your throat. They are part of your immune system, which is a complex network of cells, tissues, and organs that work together to defend the body against harmful invaders. The tonsils are vital in protecting your body from infections. They are often referred to as the "first line of defence" because they are strategically positioned to catch and filter out germs that enter through your mouth or nose. Where Exactly Are They Located? Your tonsils are situated in the pharynx, just behind the soft palate. There are two tonsils, one on each side of your throat. If you open your ...

"Naseptin: Powerful Defence Against Nasal Bacteria!"

  Everything You Need to Know About Using Naseptin Nasal Cream   If you've been dealing with nasal issues, you may have come across Naseptin nasal cream as a potential solution. Whether you suffer from recurrent nasal infections (vestibulitis), nose bleeds or simply need some relief from nasal dryness, Naseptin can be a valuable aid. In this blog, we'll cover everything you need to know about using Naseptin nasal cream to ensure you get the best results from this trusted product.   Unlocking the Power of Naseptin Nasal Cream: A Guide to Its Versatile Uses   Naseptin nasal cream, a powerful ally in nasal health, holds the key to treating infections caused by staphylococcal bacteria. This versatile cream offers much more than meets the eye, and we're here to shed light on its incredible benefits! 🌟 👃 Kicking Nose Infections to the Curb: Say goodbye to those troublesome nose infections! Naseptin comes to the rescue, targeting staphylococcal bacteria and...

What are different types of nasal sprays?

Nasal sprays are a popular form of medication for treating nasal allergy symptoms. They are sprayed directly into the nose to target the symptoms without affecting the rest of the body. There are many types of nasal sprays available, both prescription and over-the-counter. Here is a quick guide to the different types: Nasal Steroid Sprays: These are usually one of the first-line allergy therapies. They decrease inflammation within the nasal passages and relieve nasal congestion, sneezing, watery eyes, and runny nose. Many of these sprays are available over the counter. Some common generic and brand names include Budesonide, Ciclesonide, Fluticasone, Flunisolide, Mometasone, Rhinocort, Omnaris, Zetonna, Flonase, Nasonex, Nasacort, Xhance, Beconase, Nasarel, Qnasl, Vancenase, Veramyst, and Zetonna Nasal Decongestant Sprays: These sprays temporarily relieve nasal congestion by constricting the blood vessels in the nose, reducing nasal swelling and congestion. They are available over the...

Quinsy Abscess

 How to tell the difference between tonsillitis and quinsy? 🤔🩺 Tonsillitis vs. Quinsy: Spotting the Differences 🩺🤔   Feeling under the weather with a sore throat? It's essential to know the difference between tonsillitis and quinsy. Here's how to tell them apart:   1. Tonsillitis:   Symptoms: Sore throat, difficulty swallowing, fever, swollen tonsils with white or yellow patches, swollen lymph nodes in the neck, and possibly a cough and hoarse voice. Cause: Usually viral or bacterial infections, such as the common cold or strep throat. Treatment: Rest, hydration, over-the-counter pain relievers, and sometimes antibiotics for bacterial tonsillitis. 2. Quinsy (Peritonsillar Abscess):   Symptoms: Severe sore throat on one side, difficulty swallowing, fever, drooling, muffled voice, swollen tonsil on one side, swollen uvula, and possibly a visible abscess on the tonsil. Cause: Complication of untreated or inadequately treated tonsillit...

Why Some People Can't Stop Coughing

  Understanding Refractory Chronic Cough: What You Need to Know   Have you ever faced a cough that simply refuses to subside?   While most coughs resolve independently, some persist for an unacceptable length of time—weeks, months, or even years. This condition is known as refractory chronic cough (RCC), and it is a significant issue that demands attention in the medical community, especially among specialists in ear, nose, and throat (ENT) care.   In this blog post, we will clearly outline what RCC is, why it occurs, and the most promising treatments available to those suffering from relentless coughing.     What is Refractory Chronic Cough?   A chronic cough is defined as one that lasts longer than eight weeks in adults. For many individuals, it is associated with conditions such as asthma, allergies, acid reflux, or certain medications. However, there are instances where the cough continues even after these underlying causes have been effectively ad...