Tonsillectomy (with or without adenoidectomy) continues to be a commonly performed operation in the United States. Over the years, the incidence of post‐tonsillectomy hemorrhage (reported between 0% and 20%) has decreased, but continues to pose serious problems. We reviewed 1,445 tonsillectomies performed over a 2‐year period to study the incidence of post‐tonsillectomy hemorrhage. Thirty‐eight of 1,445 children (2.62%) had postoperative bleeding. The incidence of primary hemorrhage (within 24 hours) was 0.14%. Delayed hemorrhage requiring operative intervention or observation in the hospital was 1.03% and 0.76%, respectively. Ten patients (0.69%) had delayed hemorrhage of a minor nature that had stopped by the time they reached the hospital; these children were treated with observation alone and did not require hospitalization or operative intervention. The proposed reasons for this low rate of post‐tonsillectomy hemorrhage include complete preoperative coagulation screening, meticulous attention to surgical technique, use of suction‐cautery to obtain hemostasis and, possibly, use of postoperative antibiotics. Management of hemorrhage is discussed with respect to observation, surgical intervention, and blood transfusion.
This investigation examined ABR waveforms obtained at five signal intensities (20, 30, 40, 60, and 80 dB nHL) for adults and at three signal intensities (20, 40, and 80 dB nHL) for infants. ABR recordings were obtained in a quiet condition and repeated for three different intensity levels (40, 50, and 60 dBA) of background noise characteristic of a neonatal intensive care unit. The subjects were ten adults and ten infants whose ABRs were judged normal when measured at 20 dB nHL in the quiet condition. Results indicated that high levels of ambient noise (up to 60 dBA) did not influence either absolute wave V or interwave latencies measured for stimulus intensities of 60 and 80 dB nHL. ABR waveforms obtained at stimulus intensities often used for screening (i.e., 20, 30 or 40 dB nHL), however, were substantially altered for some subjects as a function of increasing levels of ambient noise. This observation was most apparent for the infant population and has important implications for the design of infant ABR screening programs.
This investigation examined ABR waveforms obtained at five signal intensities (20, 30, 40, 60, and 80 dB nHL) for adults and at three signal intensities (20, 40, and 80 dB nHL) for infants. ABR recordings were obtained in a quiet condition and repeated for three different intensity levels (40, 50, and 60 dBA) of background noise characteristic of a neonatal intensive care unit. The subjects were ten adults and ten infants whose ABRs were judged normal when measured at 20 dB nHL in the quiet condition. Results indicated that high levels of ambient noise (up to 60 dBA) did not influence either absolute wave V or interwave latencies measured for stimulus intensities of 60 and 80 dB nHL. ABR waveforms obtained at stimulus intensities often used for screening (i.e., 20, 30 or 40 dB nHL), however, were substantially altered for some subjects as a function of increasing levels of ambient noise. This observation was most apparent for the infant population and has important implications for the design of infant ABR screening programs.
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