Adult tonsillectomy: postoperative pain depends on indications

Zagólski, Olaf; Gajda, Mariusz; Stręk, Paweł; Kozlowski, Michael; Gądek, Artur; Nyzio, Jerzy

doi:10.1016/j.bjorl.2015.11.010

Cited by 7 publications

(8 citation statements)

References 30 publications

(33 reference statements)

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“…Majority of the patients in this study had their tonsil removed by cold steel (dissection) technique, which is the preferred technique in our center over electrocautery (Diathermy). Similar to previous studies that attributed the high incidence of post tonsillectomy technique used [24][25][26][27]. All patients in our study had post tonsillectomy pain, with 29.1% of them having associated otalgia.…”

Section:  Complicationssupporting

confidence: 89%

“…This is in consonant with numerous publications that post tonsillectomy pain being the commonest complication of adult tonsillectomy [26 Although pain instruments measure the severity of pain, in this study the duration of patient's response to pain with adequate analgesia was used. In previous studies visual analog scale was used to measure the intensity and the sco vary with the different surgical technique [27]. Secondary post tonsillectomy bleeding occurred…”

Section:  Complicationsmentioning

confidence: 99%

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Tonsillectomy in Adults: Analysis of Indications and Outcome in Sokoto, North Western Nigeria

Aliyu

Solomon

2019

AJMAH

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Background: Tonsillectomy is a well-established surgical procedure practiced commonly by otolaryngologist for removal of tonsils. Although being a relatively simple and common procedure, it is not without considerable complications. This study aimed to profile the indication and outcome of adult tonsillectomy in our region. Method: This was a retrospective study of all adults who had tonsillectomy in the department of Otorhinolaryngology, Usman Danfodiyo Teaching Hospital, (UDUTH) Sokoto, over a seven-year period from 1st January 2011 to 31st December 2017. All information was carefully retrieved from each patient’s case file and from the operation register. The data retrieved was subsequently analysed. Results: A total of 55 adults patients had tonsillectomy over the period of study. Age range was 18 to 45 years with a mean age of 26.3 years. There were 16 males (29.1%) and 39 females (70.9%) with a male to female ratio of 1:2.4. Recurrent tonsillitis 28(50.9%) was the commonest indication; others include: post quinsy 13(23.6%), tonsillomegally 6(10.9%); suspected neoplasm 6(10.9%); recurrent otalgia secondary to tonsillomegally 2(3.6%) Five patients had unilateral tonsillectomy for suspected neoplasm while others had bilateral tonsillectomy. Cold dissection was used in 37 (67.2%) of the patients, while 18(32.7%)were by electro cautery (Bipolar diathermy). The commonest post-operative complication was pain in all patients, followed by otalgia (29.1%) and secondary post tonsillectomy bleed in two patients. No patient had blood transfusion. Hospital average stay was 3 days. Follow up was uneventful in 16 (29.1%) of patients while 4(7.3%) patients had squamous cell carcinoma and were refered to Oncologist. The remaining 35 patients were lost to follow up. Conclusion: The commonest indication for Adult tonsillectomy is chronic recurrent tonsillitis. Histopathological analysis of every tonsil specimen is advocated.

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Section:  Complicationssupporting

confidence: 89%

Section:  Complicationsmentioning

confidence: 99%

Tonsillectomy in Adults: Analysis of Indications and Outcome in Sokoto, North Western Nigeria

Aliyu

Solomon

2019

AJMAH

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“…However, as the choice of surgical procedure was determined by the number of episodes of acute tonsillitis, it can be suspected that the ECTA group was more susceptible to postoperative pain. A study by Zagólski, et al 19) shows that the general perception of patients with recurrent tonsillitis having more post-operative pain may be due to intra-operative trauma rather than past medical history. When patients with or without recurrent tonsillitis received the same surgical tech-nique which eliminated forceful dissection, the group with recurrent tonsillitis experienced less pain.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Functional Outcomes after Powered Intracapsular Tonsillectomy with Adenoidectomy and Conventional Extracapsular Tonsillectomy with Adenoidectomy for Pediatric Obstructive Sleep Apnea

Jeon¹,

Kim²,

Bang³

et al. 2020

Korean J Otorhinolaryngol-Head Neck Surg

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Background and Objectives This study was investigated to compare the clinical outcomes and complications of powered intracapsular tonsillectomy and adenoidectomy (PITA) with those of conventional extracapsular tonsillectomy and adenoidectomy (ECTA) in treatment of pediatric obstructive sleep apnea (OSA).Subjects and Method Eighty-one children with adenotonsillar hyperplasia underwent tonsillectomy and adenoidectomy (46 PITA and 35 ECTA) from December 2016 to July 2017 for OSA. The choice of surgical procedure (PITA vs. ECTA) was determined by the number of episodes of acute tonsillitis. The quality of life measurement was performed using Korean Obstructive Sleep Apnea Survey (KOSA-18) score. Postoperative bleeding was assessed as number of revisit or readmission. Postoperative pain was evaluated by visual analog scale (VAS) at postoperative day 1, 3, and 7.Results PITA and ECTA significantly reduced KOSA-18 scores postoperatively (p＜0.01, p＜0.01, respectively) and were equally effective in pediatric OSA treatment. Postoperative bleeding was lower in the PITA group, but there was no statistical difference due to small number of cases. VAS score for postoperative pain was significantly lower in the PITA group at day 1, 3, and 7 (p=0.03, p＜0.01, and p＜0.01, respectively).Conclusion PITA is effective in pediatric OSA treatment with less morbidity, and less complications.

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“…Our results was different from Zagolski when he found that postoperative pain was less with patient with recurrent tonsillitis, although, he stated that it shoul be more logically and he reasoned that because he used different techniques for removal of the tonsils. [19] …”

Section: Discussionmentioning

confidence: 99%

Post Tonsillectomy Pain of Bipolar Electrocautery and Coldsteel Dissection: A Randomized Prospective Comparative Study

Alkhalil¹,

Mohammad²,

Al-lela³

2018

JPPCM

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Adult tonsillectomy: postoperative pain depends on indications

Abstract: Patients with recurrent tonsillitis qualified for tonsillectomy reported lower pain intensity than those without recurrent tonsillitis and the pain scores were unrelated to nerve fibers density.

Cited by 7 publications

References 30 publications

Tonsillectomy in Adults: Analysis of Indications and Outcome in Sokoto, North Western Nigeria

Tonsillectomy in Adults: Analysis of Indications and Outcome in Sokoto, North Western Nigeria

Comparison of Functional Outcomes after Powered Intracapsular Tonsillectomy with Adenoidectomy and Conventional Extracapsular Tonsillectomy with Adenoidectomy for Pediatric Obstructive Sleep Apnea

Post Tonsillectomy Pain of Bipolar Electrocautery and Coldsteel Dissection: A Randomized Prospective Comparative Study

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