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Laser Tonsillectomy
by Dr. Christopher Chang, last modified on 9/21/11
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First of all... NO... we do not offer laser tonsillectomy or laser cryptolysis (we do offer coblation cryptolysis however). Nor do we know of anybody that does it in Virginia or the mid-Atlantic region for that matter. In our office, we offer only the traditional tonsillectomy. However, because we do have plenty of patients asking about this laser procedure, we have written up this webpage.
Simply put, laser tonsillectomy is when the surgeon uses a laser beam to remove a part of the tonsil. Rarely, is an actual "tonsillectomy" performed in the traditional sense whereby the entire tonsil is completely removed. Instead, only the tonsil surface is removed or "resurfaced". Less commonly, an intracapsular tonsillectomy is performed during which the surgeon removes all of the tonsil except for a thin layer abutting the fossa where the tonsil sits inside the mouth.
ADVANTAGES:
1) Can be done awake (without general anesthesia) in adult patients as long as there is:
2) Less pain possible
3) Faster recovery than traditional tonsillectomy possible
DISADVANTAGES:
Along with risks of bleeding and dehydration found with traditional tonsillectomy, there are additional risks found when performing laser tonsillectomy including:
1) Airway fire (if a spark occurs due to laser use, it can ignite the air)
2) Blindness (laser can bounce off shiny surfaces like metal and reflect out)
3) Oral and facial burns (lasers do not burn just the tonsil, it can burn anything that gets in the way... in other words, do NOT turn your head, sneeze, cough, or gag if the laser is turned on!!!)
4) Continued problems with recurrent tonsillitis or strep throat (because in laser tonsillectomy, there's always some tonsil tissue left behind)
5) No pathology specimen to evaluate for lymphoma or tonsil cancer
6) Tonsil regrowth
7) There's some question whether there is an increased risk of life-threatening bleeding, mainly because the laser can pierce tissue like an arrow potentially. Not an ideal characteristic because the carotid artery is < 1 cm away from the tonsil. Read an article about a boy who died after laser tonsillectomy due to this complication.
Who is the ideal patient for laser tonsillectomy?
1) Adult patient
2) No gag reflex
3) Entire tonsil can be visualized when patient opens the mouth
4) Tonsil problems dealing mainly with tonsil stones or cryptic tonsils. Not chronic tonsillitis or strep throat.
5) No tonsil cancer concern
Great! I want a laser tonsillectomy! Who does them?
So far, here is a list of surgeons in the United States who offer this procedure at this time that we are aware of. If you know of anybody else, email me and I would be happy to add to this list.
Craig Schwimmer, MD (Dallas, TX)
Kenny Chan, MD (Denver, CO)
Yosef Krespi, MD (New York City)
Edgar Ling, MD (New York City)
Haitham Masri (Dearborn, MI)
Jerald Giles (New Orleans, LO)
Watch a video of laser tonsillectomy here. This movie was made with the patient under general anesthesia in order to film the procedure.
A newscast describing laser tonsillectomy by Dr. Schwimmer of Dallas, TX is shown below:
DID YOU KNOW that a person has a total of FOUR tonsils... one adenoid, two tonsils, and one lingual tonsil. The lingual tonsil is located on the back of the tongue. When lingual tonsils start to cause problems, they also can be removed.
If your tonsils and/or adenoids are affecting your quality of life, please contact our office for an appointment.
Any information provided on this website should not be considered medical advice or a substitute for a consultation with a physician. If you have a medical problem, contact your local physician for diagnosis and treatment. Advertisements present are clearly labelled and in no way support the website or influence the contents.
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