Ear, Nose & Throat insights from Mike Dilkes, expert in ENT laser surgery

Tonsil stones may need more than one laser tonsillectomy under local anaesthetic spray to completely eradicate them.

Tonsil stones appear on the tonsil surface. They form from food which gets jammed into holes and crevices on the tonsil surface.

This looks like a hole in the front lower part of the eardrum. But in fact the drum is red and retracted like it has fluid behind it. So there can't be a hole since that would let the fluid drain away. In fact therefore this is a round retraction pocket, the correct treatment is a course of steroids followed by a myringotomy if it does not settle.

Comparison of the virtues of local anaesthetic laser tonsillectomy with traditional tonsillectomy

Well it ought to be as traditional tonsillectomy is essentially unchanged over 70 years. Medicine has moved on rather a lot since then. Some of the old fashioned ENT consultants still decry the new laser procedure saying that 100% tonsil removal is always required. Personally I don't agree with that, I think symptomatic relief with as little discomfort as possible is what's required. The modern way.

Tonsil stones can be well treated by laser tonsillectomy under local anaesthetic spray.

There remains a faint line at IgG so this test is still demonstrating my immunity to covid19 having had the disease 6 months ago.

This patient had the sensation of food sticking in the back of her nose when inadvertently coughing or sneezing whilst eating. Initially I was sceptical but when examining from below with the HD endoscope I could clearly see small adenoids that had deep fissures within, where I could easily see food trapping on occasion - see photo. The treatment would probably be a form of adenoidectomy under general anaesthetic.