Tonsillectomy for Pathological Airway (Type 2) Halitosis due to Chronic Caseous Tonsillitis (CCT) with Tonsilloliths (Tonsil removal due to bad breath caused by chronic infection)

Threshold

This procedure will be funded by the Norfolk and Suffolk Integrated Care Board for the treatment of severe airway (Type 2) halitosis due to CCT if the following criteria can be met:

• Pathological halitosis (offensive smelling breath) which has been demonstrated to be due to CCT with tonsil crypt debris (tonsilloliths) with diagnosis confirmed by ENT specialist.

AND

• CCT has not responded to medical management over a period of three months. Medical management can include irrigation, saline gargling, topical antiseptic spray, anti-inflammatories.

Other N&S ICB Tonsillectomy Policies are below

Tonsillectomy for Sleep Disordered Breathing and Obstructive Sleep Apnoea for Adults – Knowledge NoW (nwknowledgenow.nhs.uk)

Tonsillectomy for Sleep Disordered Breathing and Obstructive Sleep Apnoea (OSA) in Children <16 years – Knowledge NoW (nwknowledgenow.nhs.uk)

Tonsillectomy for Recurrent Tonsillitis or its Complications (e.g. Quinsy) in Children <16 and in adults – Knowledge NoW (nwknowledgenow.nhs.uk)

Cases for Individual Funding Consideration (Patients who do not meet the policy criteria)

On a case to case basis, patients might be eligible for surgical intervention, in consideration of their exceptionality. The requesting clinician must provide information to support the case for being considered an exception, by submitting an individual funding request.