Surgery to remove the tonsils is one of the commonest procedure Neil performs. For several years now he has used a Coblation intracapsular technique for tonsillectomy. The advantages of this technique are a dramatically reduced risk of bleeding and, in most children, reduced levels of throat soreness with a quicker return to school or nursery.
Neil regularly teaches this increasingly popular technique to fellow consultants from the UK and beyond. In 2019 he was invited to demonstrate the technique at the Montreal Children's Hospital, Canada. He is a recognised expert in this technique which is revolutionising tonsillectomy both in terms of safety and recovery time.
Information for patients and carers
Why do we remove tonsils?
The commonest reason for having the tonsils removed is either for recurrent episodes of tonsillitis or snoring causing sleep disturbance or sleep apnoea.
Can my child manage without tonsils?
Yes. Although the tonsils have a role in protecting against infection, removing the tonsils and/or adenoids does not make children more prone to getting infections.
What is involved in surgery?
The operation is carried out under general anaesthetic and takes about 15 minutes. Most children can go home the same day.
Why have an intracapsular tonsillectomy?
Firstly, there is good data to suggest that it is dramatically safer from the point of view of bleeding risk and this has been Neil's observation over the last 4 years. Returning to the operating theatre with bleeding is exceptionally rare. Secondly the operation is, in general, much less painful and children return to normal function much more quickly. There is no limitation on when children can return to school or nursery- they can go back when they are back to normal and with the majority of children this is within a week. The re-admission rate with pain is much lower with this technique with standard techniques.
What will happen after the surgery?
After going home it is really important to encourage your child to eat and drink as normally as possible. There is no restriction as to what they can eat or drink. Children should have some regular painkillers (usually in the form od Ibuprofen and Paracetamol) for a week and this will be discussed with you by the nurses on the ward.
The area where the tonsils were will always look white or yellow and this is often taken to mean that it is infected. It always has this appearance and, if your child is continuing to eat and drink it is nothing to be worried about.
It is not uncommon for children to develop smelly breath after this type of surgery. If they are otherwise eating and drinking normally and do not have a persistent fever this is nothing to be worried about and will get better as things heal up.
As soon as you feel your child is back their normal self they can return to school or nursery.
What are the risks of surgery?
There is a tiny risk of bleeding. With an intracapsular tonsillectomy the risk of this is much less than 1%. Occasionally it can take a little longer for children to recover and in a very small number they can require antibiotic treatment. A very small number need admission to hospital for this.
There is always a small risk of a small piece of tonsil growing back and causing problems. The chance of this happening and needing a further operation is approximately 1%.