Ask the Expert: Tonsil removal

14 June 2019

The tonsils are lumps of tissue that lie at the back of the throat. They play a part in fighting infection, but they’re not essential to a person’s health and wellbeing.

The operation performed to remove the tonsils is called a tonsillectomy, which can cure a number of conditions from repetitive painful sore throats, to tonsil stones (quite common), bad taste, unpleasant breath and surprisingly, snoring.

Our Ear, Nose and Throat Specialist, Mr Michael Dilkes, discusses the pros and cons of capsule preserving laser tonsillectomy, which can save patients a lot of sick-leave and pain.


Tonsils can cause a lot of problems, particularly in adults. Children and young people can also suffer, but there’s an argument that they “may grow out of it”, and so surgery isn’t always required. However, if an adult is experiencing tonsil problems, then they most likely won’t “grow out of them”.

Tonsils can cause a wide variety of symptoms, including abscess (quinsy), recurrent bad sore throats, tonsil stones, bad taste/breath and snoring.

The problem with removing the tonsils as an adult is the effects a patient experiences after the surgery. Typically there is severe pain for weeks on end, the real possibility of bad bleeding, requiring readmission to hospital, and a significant amount of time off work/school are well known problems, along with scarring once it has all healed.

Nowadays, worldwide ENT surgeons are seeking methods of removing the tonsil whilst not disrupting the natural barrier between the tonsil and its surrounding blood supply - the capsule of the tonsil. Techniques that remove the tonsil while preserving the capsule are associated with much less pain, bleeding and time off work/school than traditional tonsillectomy.

The downside is that, because a small amount of tonsil tissue is left (although this is often desirable as it retains the function of the tonsils), the revision rate is around 1:50 rather than 1:100 with the traditional tonsillectomy.

At Spire London East Hospital I perform capsule preserving laser tonsillectomy as a day case, minimising time off work or school to a few days, typically much less than a traditional tonsillectomy.


If you’ve been experiencing the discussed symptoms and would like to know more about laser tonsillectomy, Mr Michael Dilkes is available to book at Spire London East Hospital on Friday afternoons. Book your appointment online.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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