Compared with tamponade treatment, HWI is as effective, requires a significantly shorter hospital stay, is less traumatic to the nose, and is significantly less painful.
In a prospective randomized clinical study the incidence of post-tonsillectomy haemorrhage was studied in 832 patients receiving either acetylsalicylic acid or paracetamol as postoperative analgesic (423 and 409 patients, respectively). Of 27 patients experiencing 1 or more bleeding episodes postoperatively, 18 received acetylsalicylic acid and 9 paracetamol. No difference was found regarding the incidence of bleeding within the first 24 h but, later on, a significantly lower incidence of secondary bleeding occurred in the paracetamol group (0.5%) compared with the acetylsalicylic acid group (3.1%). We conclude that acetylsalicylic acid is not the optimum postoperative analgesic following tonsillectomy and that other alternatives must be sought.
In 2.3% of 217 patients with peritonsillar abscess, the clinical picture was atypical, with inflammatory swelling of the pharyngeal wall below and behind the tonsil, oedema of the epiglottis and a diffuse swelling on the side of the neck. The typical signs of peritonsillar abscess, i.e. trismus, a medially displaced tonsil and displacement of the uvula toward the opposite side, were either completely lacking or less pronounced than usual. The abscesses were all located in the peritonsillar space at the lower pole or behind the tonsil. To ensure rapid, uncomplicated recovery in such cases with parapharyngeal involvement, it is essential that abscess tonsillectomy under antibiotic cover with penicillin is not postponed.
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