Mike Dilkes MS FRCS Consultant ENT Surgeon, based at HealthHub London

THIS is what we are trying hard to achieve - a message from a recent patient regarding the results of laser turbinoplasty under local anaesthetic at HealthHub:

 

"Thank you Mike for the friendly and efficient way in which you dealt with me. I really appreciate our consultations. I congratulate you on the fantastic technology you have at your Hub and the speed in which you carried out the investigations. My nose is better for the turbinoplasty treatment.

I would greatly recommend you to anyone seeking help with ENT problems.

With grateful thanks.

Norman Davies"

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A really good Cochrane review in 2009 may be worth reading for those interested in tonsil surgery. It points out that tonsil removal, even with laser, will not always remove all throat symptoms, such as recurrent sore throats, bad breath, tonsils stones etc. 

EVIDENCE-BASED CHILD HEALTH: A COCHRANE REVIEW JOURNAL

Evidence-Based Child Health 4: 1291–1326 (2009)

Tonsillectomy or adeno-tonsillectomy versus non-surgical

treatment for chronic/recurrent acute tonsillitis (Review)

Burton MJ, Glasziou PP

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In the aftermath of Covid19 and a general lack of access to most medical facilities, small modern laser equipped clinics like HealthHub remain open and are often the only way of having your tonsils or nose treated.

Private medicine can be very expensive. That's why I don't  have clinics in London's West End any more, and have helped set up HealthHub. This is a clinic in South Central London, only a few minutes from Central London by bicycle, train or car. Not quite as convenient as Harley Street but much better value plus better equipment and availability. I can control prices here, so ENT consultations including High Definition video endoscopy in clinic are £250, rather than £600+ in the West End. The same applies to insured patients, where in some Harley Street clinics the entire year's fee allowance can be expended in one consultation. I also know where the best value is for tests, scans/imaging and operations, so patients get my 25 years experience and know how, but at a reasonable price. Patients come from all over the UK, Ireland and the rest of the world.

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Laser tonsillectomy under local anaesthetic can give great value, as it costs £1250 for the first treatment, £850 for the second, £500 for any subsequent. Most patients only need one treatment (>60%) to settle their symptoms. This compares with £4000 or more for a traditional tonsillectomy under general anaesthetic.

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I use lasers and other innovative treatments to help bring costs down, as the use of lasers in particular allow treatments to be quick and uncomplicated. Common procedures include laser tonsillectomy using local anaesthetic spray (also known as tonsillotomy, tonsil resurfacing), intracapsular laser tonsillectomy under general anaesthetic, laser vapourisation of facial moles and lumps,  nose unblocking septoplasty and laser turbinoplasty under local anaesthetic, plus other forms of snoring treatment such as uvulectomy or laser palatoplasty (LAUP), also under local anaesthetic.

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Imagine going back to work straight after having your laser tonsillectomy, laser palatoplasty or laser turbinoplasty ("lunchtime treatments") in clinic, or just a few days after nose unblocking or snoring surgery under general anaesthetic in Hospital. This is what I aim for.

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I'm a great believer in medical technology, and have recently innovated digital HD endoscopy in clinic, giving a very clear and magnified view. I use it for the entire examination, including ears, so that there is no patient - doctor touching at any point. The patient has his/her own screen to observe, the examination is recorded, played back and discussed in front of the patient by the doctor, then downloaded onto a USB business card so the patient can look at their findings at home. I sometimes use a head mounted HD camera to record procedures, this can also be downloaded onto the card, so the patient goes home with the entire consultation and treatment in their pocket. Recently I've started sending patients disposable endoscope cameras, for Zoom consultations - so the patient shows me the problem.

Laser turbinoplasty uses a brand new laser system purchased from Germany, called the Holmium-YAG. Previously I've only been able to perform turbinoplasty under general anaesthetic, which was time consuming and expensive. Now it's a walk in - walk out "lunchtime" procedure under local anaesthetic in clinic.

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