Dr. David Cronin MBBS (QLD) FRACGP FRCS FRACS  Otolaryngologist  Head and Neck Surgeon

Your Questions

Questions:

What exactly are 'grommets'? Is tonsil removal necessary and safe? What are 'adenoids'? How does FESS relate to sinus trouble?

What exactly are 'grommets'? Grommets are tiny plastic tubes that are inserted into the eardrum. They are very effective in reducing the incidence of recurrent middle ear infections (otitis media) and in overcoming the deafness of accumulated mucous in the middle ear (known as 'glue ear'). Grommets are self-extruding (ie fall out themselves) usually within 12 months of insertion. And, yes, swimming is quite possible with grommets inserted, but ear plugs are recommended.

Is tonsil removal necessary and safe? Tonsillectomy is still a useful operation, not only for preventing recurrent infections but also for overcoming obstructed breathing during sleep. With modern anaesthesia, a tonsillectomy is a very safe procedure and can be extremely beneficial at any age. Post-operatively it is essential to relieve pain with paracetamol or paracetamol and codeine compounds, and also to return to eating and drinking as soon as possible. Earache after a tonsillectomy is almost universal, being a referred pain from the tonsil bed.

What are 'adenoids'? Physically separate from tonsils, the adenoids are an aggregation of lymphoid tissue at the back of the nose. They are often enlarged and infected in childhood, and can cause nasal obstruction, nasal discharge and ear infections. They are often removed at tonsillectomy, and the operation is then known as adenotonsillectomy. The adenoids shrink and virtually disappear at adolescence.

How does FESS relate to sinus trouble? These days most chronic sinus disease is treated by FESS (Functional Endoscopic Sinus Surgery). This is performed through the nostrils using fine telescopes and powerful sucking and debriding instruments. The procedure is usually done under a general anaesthetic and as a day case. It produces minimum inconvenience and is almost painless. Post-operative irrigation with saline solution will help cleanse the nose of crusts, and promote rapid healing.

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