{"id":4479,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/tonsillectomy\/"},"modified":"2023-08-30T12:09:01","modified_gmt":"2023-08-30T11:09:01","slug":"tonsillectomy","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/entadult\/throat\/tonsillectomy\/","title":{"rendered":"Tonsillectomy"},"content":{"rendered":"\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Routine referral<\/h3>\n\n\n\n<p>We now offer direct access tonsillectomy for Borders and Lothians.&nbsp; This allows patients to be&nbsp;directly listed&nbsp;for tonsillectomy and therefore avoids an outpatient consultation. In order to be listed directly, the patient must satisfy the following criteria, recommended by NICE:<\/p>\n\n\n\n<p>For people with severe recurrent tonsillitis (a frequency of more than 7 episodes per year for one year, 5 per year for 2 years, or 3 per year for 3 years, and for whom there is no other explanation for the recurrent symptoms), referral to an ear, nose, and throat specialist is advised as this cohort may benefit from tonsillectomy<\/p>\n\n\n\n<p><a href=\"https:\/\/cks.nice.org.uk\/topics\/sore-throat-acute\/management\/management\/\" target=\"_blank\" rel=\"noreferrer noopener\">Scenario: Management | Management | Sore throat &#8211; acute | CKS | NICE<\/a>.<\/p>\n\n\n\n<p>If you wish to list the patient for tonsillectomy please give the patient&nbsp;a&nbsp;<a href=\"\/files\/sites\/2\/ENT-Patient-Information-Leaflet-Having-a-Tonsillectomy-Jul-18-Approved-Jan-19.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;Patient Information leaflet &#8211; Having a Tonsillectomy&nbsp;&nbsp;<\/a>and complete the pro forma via SCI Gateway (St John\u2019s Hospital\/Lauriston Buildings &gt; ENT &gt; Direct Access Tonsillectomy)<\/p>\n\n\n\n<p>Following receipt of the completed pro forma, the patient\u2019s name will be placed on the waiting list for tonsillectomy.&nbsp; He\/she will then be sent an appointment to attend our Pre-assessment Clinic 1-2 weeks before tonsillectomy.<\/p>\n\n\n\n<p>If you are in any doubt or wish an ENT Surgeon to assess the patient in the Outpatient Clinic, please arrange a routine appointment.<\/p>\n\n\n\n<p>Once a decision is made for tonsillectomy, this should be performed as soon as possible to maximise the period of benefit.<br>Tonsillectomy has an appreciable peri-operative morbidity, a complication rate of around&nbsp;5% and the outcome is, as yet, undefined. Return to usual activity takes, on average, two weeks.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Criteria for Direct Access Tonsillectomy<\/h3>\n\n\n\n<p><strong>Direct Access Tonsillectomy<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sore throats are due to tonsillitis (i.e., tonsils are erythematous, oedematous and may have exudates)<\/li>\n\n\n\n<li>Episodes for at least one year<\/li>\n\n\n\n<li>Episodes&nbsp; are&nbsp; disabling&nbsp; and prevent normal function<\/li>\n\n\n\n<li>Seven&nbsp; or&nbsp; more&nbsp; well documented, clinically&nbsp; significant&nbsp; sore&nbsp; throats&nbsp; in&nbsp; preceding&nbsp; year&nbsp;&nbsp;&nbsp; OR<\/li>\n\n\n\n<li>Five or more episodes in&nbsp; each&nbsp; of&nbsp; the&nbsp; preceding&nbsp; two&nbsp; years&nbsp;&nbsp; OR<\/li>\n\n\n\n<li>Three&nbsp; or&nbsp; more&nbsp; episodes&nbsp; in&nbsp; each&nbsp; of&nbsp; the&nbsp; preceding&nbsp; three&nbsp; years<\/li>\n\n\n\n<li>This patient has been given a&nbsp;<a href=\"\/files\/sites\/2\/ENT-Patient-Information-Leaflet-Having-a-Tonsillectomy-Jul-18-Approved-Jan-19.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">tonsillectomy information leaflet<\/a><\/li>\n\n\n\n<li>Six months watchful waiting has not resulted in significant improvement ( particularly&nbsp; relevant&nbsp; in&nbsp; children&nbsp; and&nbsp; teenagers)<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/ENT-Globus-Syndrome-PIL-v1.0-NHSL-Approved.pdf\" data-type=\"attachment\" data-id=\"201\" target=\"_blank\" rel=\"noreferrer noopener\">ENT- Globus Syndrome PIL v1.0 NHSL Approved<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/ENT-Consensus-Statement-on-the-Mgt-of-Tonsil-stones-ENT-Scotland-Mar19.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">ENT &#8211; Consensus Statement on the Mgt of Tonsil stones ENT Scotland Mar19<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/ENT-Patient-Information-Leaflet-Having-a-Tonsillectomy-Jul-18-Approved-Jan-19.pdf\" data-type=\"attachment\" data-id=\"192\" target=\"_blank\" rel=\"noreferrer noopener\">ENT &#8211; Patient Information Leaflet -Having a Tonsillectomy Jul 18 Approved Jan 19<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/ENT-Throat-tonsillectomy-referral-form.doc\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/ENT-Throat-tonsillectomy-referral-form.doc\" target=\"_blank\" rel=\"noreferrer noopener\">ENT Throat &#8211; tonsillectomy referral form<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/feelingofsomethingstuckinthethroatfossit\/\" target=\"_blank\" rel=\"noreferrer noopener\">Feeling of something stuck throat (FOSSIT) Globus \u2013 RefHelp (nhslothian.scot)<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":4462,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[161],"class_list":["post-4479","page","type-page","status-publish","hentry","category-tonsillectomy"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/entadult\/throat\/tonsillectomy\/\" rel=\"tag\">Tonsillectomy<\/a>","rttpg_excerpt":null,"_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4479","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4479"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4479\/revisions"}],"predecessor-version":[{"id":14489,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4479\/revisions\/14489"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4462"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4479"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4479"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}