Introduction
Tonsillectomy for tonsil stones is not offered in the NHS Lothian.
Tonsil stones represent the accumulation of debris and bacteria within the crypts of the palatine tonsils. In general, they cause minimal symptoms. However, occasionally patients report bad breath (halitosis) and discomfort in the tonsil area due to the presence of these accumulations. Tonsil stones are not typically associated with acute infection such as bacterial tonsillitis, although they can co-exist in patients with a history of recurrent tonsillitis. There is no evidence that the presence of tonsil stones leads to long term health issues.
As there is a lack of evidence to support the use of tonsillectomy in the management of tonsil stones, NHS Lothian does not offer tonsillectomy for this indication.
C.M & G.T 24-04-23
As advised by ENT Scotland with the support of the Chief Medical Officer, we are not in a position to offer tonsillectomy in the NHS as the potential risks outweigh the benefits. Please also see the Scottish consensus statement on tonsillar stones.
The literature describes alternative conservative treatments for tonsil stones including gargling with salt water, expressing the tonsil stones manually using a blunt instrument (done very carefully) and a trial of a dairy-free diet.
The evidence for these is poor but they are unlikely to cause harm.
