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Post-tonsillectomy haemorrhage: a retrospective comparison of abscess- and elective tonsillectomy.

Abstract：

CONCLUSION:There is no increased risk of postoperative haemorrhage for abscess tonsillectomies in comparison to elective tonsillectomies. OBJECTIVE:There is still controversy as regards the optimal management of peritonsillar abscess. Opponents of tonsillectomy à chaud cite an increased postoperative bleeding risk. Most authors who compared the risks of postoperative haemorrhage after tonsillectomy à chaud and tonsillectomy à froid did not take into consideration criteria such as the age and gender of the patients or the experience of the surgeon. We aimed to eliminate this bias by performing a retrospective study in which a large series of abscess tonsillectomies were compared with an age- and gender-matched group of elective tonsillectomies. MATERIAL AND METHODS:All patients had been operated on at the Department of Otorhinolaryngology, University of Duisburg-Essen between March 1994 and August 2000. There were 350 patients in the abscess tonsillectomy group (61% male, 39% female; mean age 31.8 years; range 3-88 years) and 311 in the elective tonsillectomy comparison group (61% male, 39% female; mean age 30.0 years; range 2-83 years). RESULTS: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.

journal_name

Acta Otolaryngol

journal_title

Acta oto-laryngologica

authors

Lehnerdt G,Senska K,Jahnke K,Fischer M

doi

10.1080/00016480510012336

subject

Has Abstract

pub_date

2005-12-01 00:00:00

pages

1312-7

issue

eissn

0001-6489

issn

1651-2251

pii

X3M0540PP611TG87

journal_volume

125

pub_type

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Post-tonsillectomy haemorrhage: a retrospective comparison of abscess- and elective tonsillectomy.