ENT Telephone Consultation Summary Letter

Re: Telephone Consultation On 1 November 2024 I am writing to summarise what we discussed on our telephone call today about your ongoing issues with recurrent tonsillitis and snoring. Diagnosis 1. Recurrent tonsillitis 2. Obstructive sleep apnoea (suspected) Management Plan 1. Referral to sleep study clinic for assessment of obstructive sleep apnoea. 2. Prescribed a course of Amoxicillin 500mg three times a day for 7 days for current tonsillitis flare-up. 3. Discussed surgical option of tonsillectomy. Operation: Tonsillectomy Anaesthetic: General anaesthetic Admission: Day case Duration: Approximately 45 minutes 4. Advised to use saline nasal rinses twice daily. During our telephone conversation, we discussed the following. Your daughter has experienced five episodes of tonsillitis in the last six months, each requiring antibiotic treatment. These episodes are often accompanied by fever and difficulty swallowing. Any New Concerns Your daughter's mother mentioned that your daughter has also been snoring very loudly recently and often seems tired during the day, which is a new development. Your Medications And Allergies No changes to medications, herbal supplements, or allergies were noted since the last review. Investigations And Results No recent test results were discussed. A referral for a sleep study was arranged to investigate the snoring and daytime tiredness. Impression Your daughter's recurrent tonsillitis warrants consideration for tonsillectomy due to the frequency and impact on her quality of life. The new concerns regarding snoring and daytime fatigue suggest a possible component of obstructive sleep apnoea, which requires further investigation. Discussion About Surgery We discussed the option of tonsillectomy, which is the surgical removal of the tonsils, to reduce the frequency and severity of your daughter's tonsillitis. Anaesthetic: This procedure is performed under general anaesthetic. Admission: It is typically a day case procedure, meaning your daughter would go home the same day. Approximate Duration: The operation usually takes around 45 minutes. Alternatives Discussed: We discussed managing symptoms with antibiotics as an alternative, but given the recurrence, surgery is a more definitive solution. The risks and complications we discussed were: * Bleeding after surgery * Pain and discomfort for several days * Infection * Changes to voice (rare) * Damage to surrounding structures (very rare) After the surgery, your daughter would need to be off school for approximately two weeks for recovery. We also talked about the consent process, where you will have the opportunity to discuss any further questions with the surgical team before the operation. What You Can Do To Help For the current tonsillitis, ensure your daughter completes the full course of antibiotics. Encourage plenty of fluids and rest. Over-the-counter pain relief, such as paracetamol or ibuprofen, can help manage discomfort. Continue with saline nasal rinses as advised. When To Seek Urgent Help If your daughter experiences difficulty breathing, significant bleeding from the throat, or a high fever that doesn't respond to medication, please seek urgent medical attention. For severe pain, worsening symptoms, or any concerns about the antibiotics, please contact our clinic. Next Steps You will receive an appointment for the sleep study clinic in due course. We will also arrange a pre-assessment appointment prior to any planned tonsillectomy. Please do not hesitate to contact me if you have any questions or require further information. Please note this letter has been transcribed by Heidi Health, an AI transcribing tool, and has been checked for errors.