Post-tonsillectomy haemorrhage: A retrospective comparison of abscess- and elective tonsillectomy

Abstract

In the abscess tonsillectomy group, 9 patients (2.6%; confidence level 1.1-4.8%) had postoperative haemorrhages which required treatment under general anaesthesia, compared to 17 (5.5%; confidence level 3.2-8.6%) in the age- and gender-matched group of "selected" elective tonsillectomies. The difference between these two rates was not significant (p = 0.056). The fairly high rate of haemorrhages in the elective tonsillectomy group was mainly due to the effect of the age-matching procedure, which excluded a considerable number of usually unproblematic tonsillectomies for tonsillar hyperplasia in young children. Moreover, our results show that there is a learning curve for surgeons performing tonsillectomies with regard to postoperative haemorrhages.

The effect of ibuprofen on postoperative hemorrhage following tonsillectomy in children

“…Some authors reported that suture ligation was associated more with primary hemorrhage, and cauterization was associated more with secondary hemorrhage [12,13]. While a history of recurrent tonsillitis is associated with an increased rate of PTH as a result of scarring and neo-vascularization of infected tonsils, abscess tonsillectomy is not a risk factor for PTH in comparison to elective tonsillectomy [4,12]. Seasonal variation is not found for PTH [9].…”

Bilateral intratonsillar abscess: A novel management approach to a rare condition

“…[1] Elective tonsillectomy is associated with lower complications than hot tonsillectomy with a national tonsillectomy audit rate of bleeding, necessitating operating theatre being 1% in the elective setting compared to 2.8% of hot tonsillectomies. [10] The benefits of needle aspiration are that it can be performed immediately in the emergency department or the ward and avoids the need for general anesthetic, and the risks of intubating a compromised airway. This is particularly the case in a nondiabetic patient in whom the risk of recollection is less than a diabetic patient.…”

Nachblutungen und Gerinnungsstörungen bei Tonsillektomien

“…B. in der richtigen Schicht zu präparieren, mit einem erhöhten (Nach-)Blutungsrisiko einhergeht. So hat dieses auch Lehnert in einer Studie aus dem Jahr 2005 angedeutet, allerdings gibt es auch Studien, die diese Hypothese widerlegen [12,13,18], und auch unsere frühere Studie hat die Erklärung des erhöhten Nachblutungsrisikos durch unerfahrene Assistenten nicht bestätigt [9]. In unserem Patientenkollektiv kam es nach der ausschließ-lich angewandten warmen Dissektion mit der Koagulationsschere und Blutstillung mittels bipolarer Koagulation und sekundärem Tupferdruck hauptsächlich zu Sekundärblutungen, was zu den Erfahrungen anderer Autoren [21,22,27,28] passt.…”