Tonsil & Throat Surgery in Sydney

Tonsil and throat surgery encompasses procedures on the tonsils, adenoids, voice box and swallowing structures. At Central Sydney ENT, our surgeons perform tonsillectomy, adenoidectomy, microlaryngoscopy with vocal cord surgery, and investigation of swallowing disorders for both adults and children across seven Sydney locations.

Tonsillectomy

Tonsillectomy is the surgical removal of the palatine tonsils. While historically associated with childhood, tonsillectomy is increasingly performed in adults and remains one of the most common ENT operations worldwide.

Indications for Tonsillectomy

• Recurrent tonsillitis: five or more documented episodes of tonsillitis per year, or three or more per year over two consecutive years
• Chronic tonsillitis: persistent sore throat, bad breath and tonsillar debris unresponsive to antibiotics
• Peritonsillar abscess: particularly if recurrent, tonsillectomy prevents future episodes
• Obstructive sleep apnoea: enlarged tonsils contributing to airway obstruction during sleep
• Tonsilloliths (tonsil stones): recurrent tonsil stones causing halitosis and discomfort

Surgical Technique

Tonsillectomy is performed under general anaesthesia through the open mouth. Our surgeons use bipolar electrocautery or coblation to remove the tonsils from their capsule. The procedure takes approximately 30 to 45 minutes. Most patients go home the same day, though some adults may require an overnight stay for pain management and to ensure adequate oral intake.

Adenoidectomy

Adenoidectomy is the removal of the adenoid pad, a collection of lymphoid tissue at the back of the nose. It is most commonly performed in children aged two to eight years.

When Is Adenoidectomy Recommended?

• Nasal obstruction and mouth breathing: enlarged adenoids block the nasal airway, forcing children to breathe through their mouth
• Recurrent otitis media with effusion (glue ear): adenoids can obstruct the Eustachian tube, trapping fluid in the middle ear
• Obstructive sleep apnoea in children: adenotonsillar hypertrophy is the primary cause of paediatric OSA
• Chronic rhinosinusitis in children: enlarged, infected adenoids serve as a reservoir for sinus infections

Adenoidectomy is performed as a day procedure under general anaesthesia, usually combined with tonsillectomy or grommet insertion. Recovery is typically quicker than tonsillectomy, with most children returning to normal activities within five to seven days.

Microlaryngoscopy and Vocal Cord Surgery

Microlaryngoscopy is a procedure that allows the ENT surgeon to examine and operate on the vocal cords with high magnification using an operating microscope. A rigid laryngoscope is placed through the mouth to expose the larynx, providing a stable, magnified view of the vocal cords.

Conditions Treated with Microlaryngoscopy

• Vocal cord polyps: benign swellings on the vocal cord edge, typically caused by vocal strain or irritants
• Vocal cord nodules: bilateral callous-like thickenings from chronic voice overuse
• Vocal cord cysts: fluid-filled lesions within the vocal cord that affect voice quality
• Reinke oedema: diffuse swelling of the vocal cords, strongly associated with smoking
• Laryngeal papillomas: viral-induced growths on the vocal cords or larynx
• Leukoplakia and dysplasia: white patches on the vocal cords that may represent pre-cancerous change
• Early vocal cord cancer: small cancers confined to the vocal cord can be excised endoscopically with laser

Voice rest is recommended for one to two weeks after vocal cord surgery. Speech pathology input before and after surgery optimises voice outcomes. Patients are reviewed with repeat nasendoscopy at six weeks to confirm healing.

Swallowing Disorders

Difficulty swallowing (dysphagia) can arise from structural, neurological or inflammatory causes. Central Sydney ENT offers comprehensive assessment including flexible endoscopic evaluation of swallowing (FEES), barium swallow co-ordination, and direct pharyngoscopy under anaesthesia to identify the cause and plan treatment.

Common causes include pharyngeal pouch (Zenker diverticulum), cricopharyngeal spasm, post-radiotherapy stricture, and globus pharyngeus (the sensation of a lump in the throat). Treatment ranges from medical management and speech pathology to endoscopic or surgical intervention depending on the underlying cause.

Our Surgeons

All procedures are performed by our team of six FRACS-qualified ENT surgeons: Dr Arjuna Ananda, Dr Philip Yeung, Dr Rahuram Sivasubramaniam, Dr Alexander Zhang, Dr Sam Hwang, and Dr Jareen Ebenezer. Each surgeon has fellowship training in head and neck surgery and extensive experience in tonsil, throat and voice procedures for adults and children.

Related Conditions

Tonsil and throat surgery relates to several conditions managed at Central Sydney ENT:

• Tonsillitis: recurrent or chronic infection of the tonsils
• Peritonsillar Abscess: a complication of tonsillitis requiring drainage and often tonsillectomy
• Hoarse Voice: often caused by vocal cord lesions amenable to microlaryngoscopy
• Vocal Cord Lesions: polyps, nodules and cysts treated with microsurgery
• Dysphagia: swallowing difficulty investigated and managed by our team
• Adenoid Hypertrophy: enlarged adenoids in children causing nasal obstruction and ear problems