Outpatient
laser ablation of the palatine tonsils under local anaesthetic is an alternative technique to capsular
tonsillectomy for recurrent
tonsillitis under general anaesthetic.
Laser tonsillotomy ablates up to 70% of the tonsillar tissue and is performed when patients choose not to have a conventional
tonsillectomy, or are unfit for a general anaesthetic. The technique described here is an adaptation of Krespis'
laser-assisted serial
tonsillectomy (LAST) whereby only one sitting is required. Krespis' technique effectively eliminates recurrent
tonsillitis in 96% of the cases over a 4-year follow-up period and represents the only substantial study looking at treating recurrent
tonsillitis with outpatient
laser ablation. This study is a retrospective postal survey of 19 patients who underwent
laser tonsillar ablation under local anaesthetic for recurrent chronic
tonsillitis from 1997 to 2001 and was performed in liaison with the clinical audit department at Basildon Hospital. We had a response rate of 74% and an admission rate of 0%, which compares favourably with day case
tonsillectomy surgery. Of the patients, 75% did not experience further episodes of
tonsillitis 12 months after the procedure and 77% of the patients were glad they had the operation. Although this technique does not completely eliminate
tonsillitis, it offers an alternative for those patients who prefer a procedure that is done quickly in an outpatient setting without the additional problems of general anaesthesia, overnight hospital admission and long waiting lists.