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Patient Information for Laser Tonsil Resurfacing

What is Laser Tonsil Resurfacing?

Laser tonsil resurfacing, or sometimes called tonsil cryptolysis, is a state-of-the-art medical procedure aimed at improving the health and function of the tonsils without complete removal. This technique utilizes laser technology to precisely target and treat specific areas of the tonsils, addressing issues such as chronic inflammation, infections, or discomfort. This method is eloquent and bypasses the need for general anesthesia. It is performed in office with local anesthesia in just 30 minutes.

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Indications for Laser Tonsil Resurfacing:

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The laser tonsil resurfacing procedure may be considered for individuals experiencing:

  • Chronic Tonsillitis: Persistent inflammation or infections of the tonsils.

  • Tonsil Hypertrophy: Enlarged tonsils that may contribute to breathing or swallowing difficulties.

  • Tonsil Stones: Recurrent formation of tonsil stones causing discomfort or bad breath.

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  1. Decreased Pain: 80% of patients are back to full diet by a week, compared to 2 weeks for tonsillectomy.

  2. Faster Return to Work: 80% of patients are back to work by day 7.

  3. Less Bleeding: Traditional tonsillectomy has a 5% risk of bleeding post-operatively compared to the laser of only 2%.

  4. Short wait time: Operative resources are on a decline in Ontario and come with huge surgery wait times. This procedure can be done in office with local anesthesia not necessitating  a wait.

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Wong Chung, J. E. R. E. et al. Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults: A Randomized Clinical Trial. JAMA network open, 5(2), e2148655.

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Risks and Drawbacks of the Laser Tonsil Resurfacing Procedure
 

  1. Symptom recurrence rate: Laser tonsil resurfacing leaves a portion of your tonsils resulting in the improved pain and recovery. However that portion left can develop recurrence of your stones or infections. 70-80% of patients will have complete resolution. 20% of patients, while usually having milder symptoms, may need a 2nd procedure.

  2. Cost: Unfortunately due to the need of expensive specialized equipment, this procedure is not covered by OHIP and is private pay. Please see below for cost.

  3. Patient selection limitations: Having a previous peritonsilar abscess is contraindicated in this approach. The ideal patient must also have good mouth opening, be able to tolerate local anesthesia procedures, and be able to hold their breath for about 10 seconds.

Benefits of the Laser Tonsil Resurfacing Procedure
What Happens During The Tonsil Resurfacing Procedure?

When scheduled for a laser tonsil resurfacing procedure, this is usually what you can expect:

  1. Light meal: You can eat the day of but should not have a heavy meal prior.

  2. Driving:  Have someone drive you to the office and pick you up as well.

  3. Pain medication: Take 1000 mg of acetaminophen just prior to your procedure as it will help with the pain afterwards.

  4. Local Anesthesia: The procedure is typically performed under local anesthesia to ensure your comfort. We will give you topical liquid gargle and swallow. Following, injection of local anesthesia will be done into both of your tonsils.

  5. Laser Application: A specialized laser is used to precisely target and treat specific areas of the tonsils. In general it will take about 15 minutes for each side. The pace allows for frequent pauses whenever needed by you. There should be fairly no pain during the actual evaporation of your tonsil.

  6. Recovery: After the procedure, you will be given a popsicle and monitored for 30 minutes. If no issues, then you will be free to leave. You will still want to hold off on eating until the local anesthetic has worn off in about 2 hours. 

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Pre-Operative Instructions for Laser Tonsil Resurfacing

You will need to have a consult with the physician to determine if you are the right candidate for this procedure. Patients need to have an adequate mouth opening and no other medical contraindications.

 

Desensitize gag reflex: There are a few exercises that can be done to lower this which will improve the overall comfort during the procedure. The exercises are shown to be very effective after just 2 weeks, but we suggest starting at least 4 weeks prior.

 

1.    Using a soft toothbrush to brush your tongue until you reach the area that makes you feel like you might gag. If you gag, you have brushed too far. For about 15 seconds, brush that area. Generally start with a lighter touch and slowly apply more pressure.

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2.     Repeat the process twice per day when you would normally brush your teeth. 

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3.     Then move the brush slightly further back ¼ to ½ inch and repeat the process, moving the brush further and further back until you come to your tongue’s farthest visual point and brush even your tonsils.

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Downtime: Most people will only need 7 days off work and some can return sooner even. Traditional tonsillectomy is a full 14 days. 

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Post-Operative Instructions

Following your laser tonsil resurfacing procedure, adhere to these post-operative care instructions:

  • Pain Management: We will give you a prescription pain medication that you can take if acetaminophen and ibuprofen are not enough. Generally for adults can take acetaminophen 1000 mg every 6 hours (no more than 4000 mg in a day) and ibuprofen 400 mg every 6 hours.

  • Hydration and Diet: Stay hydrated by drinking plenty of fluids but avoid very hot or spicy or hard foods that could irritate the throat. Stick to a soft diet initially.

  • Activity: Avoid strenuous activities and lifting over 20 lbs for the first week following the procedure to facilitate healing.

  • Follow-Up Appointments: Generally most people do well after a week and routine follow up is not necessary. We will follow up by phone to ensure you are doing well. However if any concerns please do not hesitate to book an in office follow up.

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Potential Complications and When to Seek Medical Attention:

While Laser Tonsil Resurfacing is generally safe, be sure to monitor for any sign of complications.

 

Contact your healthcare provider if you notice:​

  • Bleeding, if small tinge contact us but you likely need to go to the emergency room if any more substantial bleeding.

  • Worsening, unmanageable pain

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If you are interested in pursuing this innovative procedure for your tonsils with Dr. Karamy, please contact us​. 

Laser Tonsil Resurfacing

 

Welcome to our patient information page about laser tonsil resurfacing. You can learn more about what to expect when you are scheduled for a tonsil resurfacing procedure. Find pre- and post-operative instructions here.

Have any questions about your upcoming laser tonsil resurfacing procedure with Dr. Karamy?

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Disclaimer

The information provided on this webpage is for educational purposes only and should not replace medical advice. Please consult with a healthcare professional for a proper diagnosis and individualized treatment recommendations.

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