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Partial tonsillectomy or tonsillotomy for adult tonsil disease. It must be the way forward.

Problems with the tonsils are well accounted for in this blog. The old fashioned extra capsular tonsillectomy cannot be justified in all but the most severe cases. From a quality of life perspective the suffering from this procedure could be considered greater than the patient's suffering from tonsil problems, although that's hard to judge over a lifetime.

A lesser procedure to remove the majority of the tonsils, perhaps not totally curing symptoms but far more acceptable in terms of post operative morbidity should be popularised and taken up by healthcare providers worldwide.

These procedures can be performed under local anaesthetic spray (carbon dioxide laser vapourisation with a 6mm diameter vapourising area via computerised pattern generator) or general anaesthetic (same laser, or radiofrequency ablation or microdebrider). The advantages of less pain, earlier return to work, reduced readmission rate with pain or bleeding, lower long term complication rate, are obvious.

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