"Breath of Fresh Air: Tonsillectomy for Halitosis Relief"

When it comes to patients complaining of bad breath (halitosis), it's crucial to distinguish between objective halitosis and subjective complaints. Relying solely on patients' self-assessments of their condition can be unreliable. Here's why we need to take a more comprehensive approach:

👃 Subjective vs. Objective Halitosis: Simply asking patients if they believe they have halitosis may not be enough. Some may have subjective complaints, which means they perceive bad breath when it may not be present. Treating these patients for odour elimination can be ineffective and ethically concerning.

👩‍⚕️ Confirming Tonsillar Aetiology: If tonsillar issues are suspected as the cause of halitosis, it's essential to confirm this reliably. Standard therapies like tongue scraping can help rule out oral halitosis.

🏥 Medical vs. Surgical Approach: Before considering surgical options, it's advisable to attempt medical resolution. Surgical interventions may have comparable efficacy, but robust evidence is still lacking. Complete removal of the crypt system is theoretically favourable, although cryptolysis, a less invasive procedure, can also be efficacious.

👶 Adults vs. Children: Tonsillar surgical procedures for halitosis are more commonly performed in adults, as the tonsils become less biologically significant with age. However, the risks of tonsillectomy are relatively higher in adults.

🌡️ Post-Operative Considerations: It's important to note that halitosis can worsen initially after surgical interventions due to post-tonsillectomy eschar. This temporary condition can last for about two weeks, with some parameters changing up to 4 weeks postoperatively.

The choice between medical and surgical approaches should be based on individual factors, including the patient's age, halitosis severity, and preference. It's essential to weigh the risks, benefits, and total treatment costs, including recovery time. Discussion with a healthcare professional is crucial in making an informed decision. If you have any questions or experiences, please drop them in the comments below. 🗨️💪

Classification of Halitosis

Type 0: physiologic	The physiologic odour is present in all healthy individuals. It is formed by the physiologic contributions from the following types. The levels of physiologic halitosis fluctuate but stay under halitometric limits and do not disturb the patient's social environment. No treatment is needed beyond reassurance.
Type 1: oral	Odour in association with an oral pathology, for example, tongue coating, periodontitis, xerostomia, and plaque stagnation.
Type 2: airway	Odour in association with respiratory tract pathologies, from the nasal cavity to alveoli, for example, rhinosinusitis, laryngitis, bronchiectasis, and carcinomas.
Type 3: gastro-esophageal	Odour in association with gastroesophageal pathology, for example, erosive gastro-oesophagal reflux disorder, gastritis with H. pylori infection, Zenker diverticulum, and gastrocolic fistula.
Type 4: blood-borne	During gas exchange, odorant volatiles from the systemic circulation are transferred to the exhaled breath. Hepatic, renal, digestive, and endocrine system disease, including trimethylaminuria.
Type 5: subjective	The patient believes there is halitosis, but no odour is detectable clinically, for example, retronasal olfaction, psychologic (olfactory reference syndrome), and neurologic conditions (e.g., chemosensory dysfunction).

Mr Gaurav Kumar

Ear, Nose & Throat Consultant

Consulting at Spire London East, Spire Hartswood Brentwood, Nuffield Health Brentwood

To book an appointment, visit https://tinyurl.com/GKAppointmentBooking

Phone Number: 07494914140

Disclaimer: For general information only, always seek medical advice from your treating consultant.

Coblation Tonsillectomy

Hi Guys, Let us talk about your tonsils and adenoids. Tonsils and adenoids are part of the immune system and help fight germs. Sometimes these tissues become infected and is called tonsillitis. When you have tonsillitis, you can feel sore to eat and drink, have the temperature, and can even have difficulty in breathing. This can be treated by a procedure called Tonsillectomy. Mr Kumar may advise you to have your tonsils removed if you have tonsil stones, if your airway is blocked due to large tonsils making you choke at night ie sleep apnoea or one tonsil is bigger than other. Tonsillectomy can be done by the traditional techniques using cold steel, electrocautery or coblation. Cold steel and elctrocautery has moderate to severe pain in postoperative period. With new coblation technique, post operative pain is very low leading to quicker recovery. Coblation is an advanced technology that combines gentle radiofrequency energy with natural saline — to quickly, and safely r...

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...

"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...

Septoplasty vs Septorhinoplasty: What’s the Difference and Which Surgery Do You Need?

Septoplasty vs Septorhinoplasty: Understanding Your Nose Surgery Options Difficulty breathing through the nose can significantly affect sleep, exercise, work and overall quality of life. Some patients also feel unhappy with the appearance of their nose following injury, previous surgery or natural development. Two commonly discussed procedures are septoplasty and septorhinoplasty . Although the names sound similar, the operations are designed to treat different problems. This guide explains the differences between these procedures, when surgery may be appropriate, and what patients should expect during recovery. What is the nasal septum? The nasal septum is the internal wall that separates the two nasal passages. Ideally, it sits centrally and allows air to flow evenly through both sides of the nose. However, many people have a deviated septum , where the septum bends to one side. A deviated septum can cause: Persistent nasal blockage Difficulty breathing through th...

Earbuds vs Over-Ears: Which One Is Silently Damaging Your Hearing?

Headphones are no longer an occasional accessory—they’re part of daily life. From early-morning podcasts to late-night playlists, our ears are spending more time under acoustic load than ever before. But a question keeps coming up in clinics, classrooms, and conversations around ear health: Are earbuds worse for your hearing than over-ear headphones? Let’s move beyond opinion and aesthetics. By looking at sound pressure levels , hygiene , and long-term listening behaviour , we can reach a clear, evidence-informed conclusion. 1. Sound Pressure Levels: Distance Matters More Than You Think The single most important factor in headphone-related hearing risk is the amount of sound energy that reaches the inner ear . Earbuds (In-Ear Headphones) Sit millimetres from the eardrum Deliver sound directly into the ear canal Require lower absolute power , but often result in higher sound pressure at the cochlea Users tend to increase volume in noisy environments (commuting, g...

"Exploring Post-Grommet Complications: What You Need to Know"

Navigating Postoperative Complications of Grommet Insertion: A Comprehensive Guide Grommet insertion, a standard surgical procedure to alleviate symptoms of middle ear disorders, can sometimes be accompanied by postoperative complications. Among these, one of the most frequently encountered issues is otorrhea or ear discharge. Understanding the nature of postoperative complications and their management is crucial for patients and healthcare providers. Types of Otorrhea Postoperative otorrhea manifests in various forms, including early, delayed, chronic, and recurrent. Early otorrhea occurs within four weeks of surgery, while delayed otorrhea surfaces four or more weeks post-surgery. Chronic otorrhea persists for three months or longer, while recurrent otorrhea involves three or more discrete episodes. Studies suggest that ear discharge after grommet insertion affects a significant proportion of patients, with rates varying from 16% to as high as 80%. Prophylactic Measures and Trea...

Adult Tonsillectomy Recovery: Day-by-Day Guide After Tonsil Surgery

Adult Tonsillectomy Recovery: What to Expect Day by Day Adult tonsillectomy can significantly improve quality of life for people struggling with recurrent tonsillitis, chronic sore throats or repeated throat infections. However, recovery after adult tonsil surgery is often more uncomfortable than many patients expect. Understanding the normal stages of recovery can help reduce anxiety and allow patients to prepare properly before surgery. This guide explains what adults commonly experience after tonsillectomy, how to support recovery safely, and when to seek urgent medical advice. Why is adult tonsillectomy recovery difficult? The tonsils sit in an area that moves constantly during swallowing, eating and speaking. After surgery, the throat heals gradually over approximately two weeks. Adults generally experience: Significant throat pain Pain when swallowing Ear pain (referred pain from the throat) Tiredness and reduced energy Disturbed sleep Temporary bad brea...

Glue Ear & Grommet Surgery for Children in London & Essex | Mr Gaurav Kumar

Glue Ear and Grommet Surgery: A Guide for Parents in London and Essex It can be distressing for parents when a child seems "inattentive," struggles with speech development, or suffers from repeated ear infections. Often, the culprit is Glue Ear (Otitis Media with Effusion)—a condition where the middle ear becomes filled with a thick, glue-like fluid instead of air. While glue ear often clears up on its own, persistent cases can impact a child’s learning and quality of life. This guide explains when to seek a private ENT consultation and how grommet surgery can help. What is Glue Ear? Glue ear occurs when the Eustachian tube, which connects the middle ear to the back of the throat, does not function correctly. This prevents air from entering the ear and allows fluid to build up. In children, Eustachian tubes are shorter and more horizontal, making them more prone to blockages following colds, flu, or allergies. Signs Your Child May Have Glue Ear Because children may not alw...

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. ...

Private Microsuction Ear Wax Removal London & Essex

Microsuction Ear Wax Removal in London & Essex: A Safer Way to Clear Blocked Ears Earwax is a natural, protective substance produced by the body to trap dust and prevent infections. However, when it builds up excessively, it can cause discomfort, hearing loss, and even dizziness. If you are experiencing "clogged" ears, seeking professional intervention from an ENT specialist is the safest way to restore your hearing and comfort. Why Does Ear Wax Build Up? While the ears are generally self-cleaning, several factors can lead to an accumulation of wax (cerumen): Narrow or Hairy Ear Canals: This makes it harder for wax to migrate out naturally. Age: Wax tends to become harder and drier as we get older. Hearing Aids or Earplugs: These can push wax deeper into the canal and prevent natural clearance. Cotton Buds: Using swabs often "tamps" the wax against the eardrum, making it harder to remove and increasing the risk...

ENT conditions (Mr Gaurav Kumar)

Search This Blog

Featured post

Glue Ear in Children: Signs, Hearing Concerns and When Grommets May Help