Informed consent for tonsillectomy - A cross-sectional survey

Adult tonsillectomy remains a common NHS procedure with variable reported complication risks. This study evaluated the consenting process by comparing complications discussed by ENT surgeons with patient expectations. Nine complications were identified via literature review. Questionnaires were distributed to ENT surgeons and adult patients; surgeons reported routinely discussed risks, while patients rated concern (1-10) and indicated expected disclosure. Responses from 44 surgeons and 43 patients were analysed. Surgeons most frequently discussed bleeding, pain, return to theatre and dental injury. Less commonly addressed were blood transfusion (64%), temporomandibular joint dysfunction (41%), taste disturbance (36%) and long-term swallowing difficulties (27%). Over 80% of patients expected disclosure of all complications, with mean concern scores between 5 and 6. These findings highlight a gap between current consenting practices and patient expectations. In line with Montgomery v Lanarkshire, discussing all material risks is essential to support informed decision-making and reduce medicolegal risk.