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Journal articles on the topic 'Tonsillectomy'
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Zhou, Xuanchen, Anting Xu, Xiaoyue Zhen, Kun Gao, Zhaoyang Cui, Zhiyong Yue, and Jie Han. "Coblation tonsillectomy versus coblation tonsillectomy with ties in adults." Journal of International Medical Research 47, no. 10 (August 28, 2019): 4734–42. http://dx.doi.org/10.1177/0300060519867822.
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Objective This study was performed to compare the intraoperative and postoperative courses of coblation tonsillectomy and coblation tonsillectomy with ties in adults. Methods All patients who underwent tonsillectomy from July 2012 to September 2016 were retrospectively reviewed. Intraoperative and postoperative bleeding, pain, and return to normal food intake were compared between patients who underwent coblation tonsillectomy and those who underwent coblation tonsillectomy with ties. Results Of 515 patients, 300 (58.3%) underwent coblation tonsillectomy and 215 (41.7%) underwent coblation tonsillectomy with ties. Twenty-five (4.9%) patients developed postoperative hemorrhage, 22 (88.0%) of whom had undergone coblation tonsillectomy and 3 (12.0%) of whom had undergone coblation tonsillectomy with ties. Patients who underwent coblation tonsillectomy reported less pain than those who underwent coblation tonsillectomy with ties. Patients who underwent coblation tonsillectomy with ties resumed a normal diet significantly later than those who underwent coblation tonsillectomy (10.0 ± 3.2 vs. 8.2 ± 1.9 days, respectively). Conclusion Coblation tonsillectomy is associated with less intraoperative bleeding, a shorter surgery time, less postoperative pain, and fewer days to recovery of a normal diet than is coblation tonsillectomy with ties. However, coblation tonsillectomy with ties is associated with remarkably reduced postoperative hemorrhage.
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Reyes, Niel Khangel. "Post-Operative Bleeding in Tonsillectomy versus Tonsillectomy with Fossa Closure in a Tertiary Military Hospital: A Cohort Study." Philippine Journal of Otolaryngology Head and Neck Surgery 35, no. 1 (May 17, 2020): 36–38. http://dx.doi.org/10.32412/pjohns.v35i1.1277.
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ABSTRACT
Objective: To determine the incidence of post-operative bleeding among patients who underwent tonsillectomy alone versus tonsillectomy with fossa closure at the Victoriano Luna Medical Center from January 2015 to December 2017.
Methods:
Design: Retrospective Cohort Study
Setting: Tertiary Military Hospital
Patients: Medical records of 83 patients that underwent tonsillectomy under the Department of Otorhinolaryngology – Head and Neck Surgery between January 2015 to December 2017 were retrospectively reviewed for data regarding sex, age, tonsillectomy with or without fossa closure and post-operative bleeding. Cases of tonsillectomy alone versus tonsillectomy with fossa closure were compared (particularly with respect to post-operative bleeding), tabulated and statistically analyzed using risk ratio and t-test.
Results: There were 57 cases of tonsillectomy alone versus 26 cases of tonsillectomy with fossa closure. The incidence of bleeding in all cases of tonsillectomy whether tonsillectomy alone or with fossa closure was 4.8%. The incidence of bleeding was higher in cases of tonsillectomy with fossa closure at 11.5% (versus 1.8% in tonsillectomy alone). Post-operative bleeding was 0.1 times more likely to occur in patients who underwent tonsillectomy alone than those who underwent tonsillectomy with fossa closure but there was no statistically significant difference in the risk of post-operative bleeding between the two.
Conclusion: Although the incidence of bleeding was higher in cases of tonsillectomy with fossa closure, our results suggest that there is no statistically significant difference in risk for postoperative bleeding between tonsillectomy alone or tonsillectomy with fossa closure.
Keywords: tonsillectomy; postoperative bleeding; tonsil pillars; suturing
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Elbadawey, M. R., H. M. Hegazy, A. E. Eltahan, and J. Powell. "A randomised controlled trial of coblation, diode laser and cold dissection in paediatric tonsillectomy." Journal of Laryngology & Otology 129, no. 11 (September 18, 2015): 1058–63. http://dx.doi.org/10.1017/s0022215115002376.
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AbstractObjective:This study aimed to compare the efficacy of diode laser, coblation and cold dissection tonsillectomy in paediatric patients.Methods:A total of 120 patients aged 10–15 years with recurrent tonsillitis were recruited. Participants were prospectively randomised to diode laser, coblation or cold dissection tonsillectomy. Operative time and blood loss were recorded. Pain was recorded on a Wong–Baker FACES®pain scale.Results:The operative time (10 ± 0.99 minutes), blood loss (20 ± 0.85 ml) and pain were significantly lower with coblation tonsillectomy than with cold dissection tonsillectomy (20 ± 1.0 minutes and 30 ± 1.0 ml;p= 0.0001) and diode laser tonsillectomy (15 ± 0.83 minutes and 25 ± 0.83 ml;p= 0.0001). Diode laser tonsillectomy had a shorter operative time (p= 0.0001) and less blood loss (p= 0.001) compared with cold dissection tonsillectomy. However, at post-operative day seven, the diode laser tonsillectomy group had significantly higher pain scores compared with the cold dissection (p= 0.042) and coblation (p= 0.04) tonsillectomy groups.Conclusion:Both coblation and diode laser tonsillectomy are associated with significantly reduced blood loss and shorter operative times compared with cold dissection tonsillectomy. However, we advocate coblation tonsillectomy because of the lower post-operative pain scores compared with diode laser and cold dissection tonsillectomy.
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Iqbal, Muhammad, Dileep Kumar, and Noor Alam Ansari. "TONSILLECTOMY;." Professional Medical Journal 24, no. 08 (August 8, 2017): 1237–40. http://dx.doi.org/10.29309/tpmj/2017.24.08.1007.
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Objective: To compare the effectiveness of dissection and diathermytonsillectomy in children and adults. Study Design: Comparative, interventional study.Setting: ENT Department of Peoples University of Medical and Health Sciences (For women)Nawabshah (SBA). Period: January 2009 to December 2011. Methods: 100 Patients of bothgenders, age ranging between 6 to 35 years, divided in two equal half as groups A and Baccording to surgical procedures were included in study. In group A, Electro diathermytonsillectomy was done, while in group B dissection tonsillectomy was applied. Results: Ingroup A, Electro diathermy tonsillectomy group, postoperative moderate to severe pain, thickslough oedema referred otalgia and haemorrhage was seen. 07 Patients developed secondaryhaemorrhage while in group B postoperative mild to moderate pain was seen. Only 02 Patientsdeveloped secondary haemorrhage in group B. Conclusion: Dissection Tonsillectomy is thebest procedure in children and adults till yet.
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Risser, Nancy, and Mary Murphy. "Tonsillectomy." Nurse Practitioner 30, no. 10 (October 2005): 66. http://dx.doi.org/10.1097/00006205-200510000-00017.
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Burton, M. "Tonsillectomy." Archives of Disease in Childhood 88, no. 2 (February 1, 2003): 95–96. http://dx.doi.org/10.1136/adc.88.2.95.
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Messner, Anna H. "Tonsillectomy." Operative Techniques in Otolaryngology-Head and Neck Surgery 16, no. 4 (December 2005): 224–28. http://dx.doi.org/10.1016/j.otot.2005.09.005.
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Edelmann, ChesterM. "Tonsillectomy." Lancet 346, no. 8982 (October 1995): 1110. http://dx.doi.org/10.1016/s0140-6736(95)91789-6.
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McClairen, Willie C., and Melvin Strauss. "TONSILLECTOMY." Laryngoscope 96, no. 3 (March 1986): 308???310. http://dx.doi.org/10.1288/00005537-198603000-00013.
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Wilson, Janet A., I. Nick Steen, Catherine A. Lock, Martin P. Eccles, Sean Carrie, Ray Clarke, Haytham Kubba, Chris H. Raine, Andrew Zarod, and John Bond. "Tonsillectomy." Otolaryngology–Head and Neck Surgery 146, no. 1 (September 22, 2011): 122–28. http://dx.doi.org/10.1177/0194599811422011.
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Wood, J. M., M. Cho, and A. S. Carney. "Role of subtotal tonsillectomy (‘tonsillotomy’) in children with sleep disordered breathing." Journal of Laryngology & Otology 128, S1 (November 26, 2013): S3—S7. http://dx.doi.org/10.1017/s0022215113003058.
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AbstractIntroduction:Sleep disordered breathing in children causes disturbance in behaviour and also in cardiorespiratory and neurocognitive function. Subtotal tonsillectomy (‘tonsillotomy’) has been performed to treat sleep disordered breathing, with outcomes comparable to established therapies such as total tonsillectomy or adenoidectomy. This review critically assesses the role of subtotal tonsillectomy in a paediatric setting.Method:The Medline database (1966 to October 2012) was electronically searched using key terms including subtotal or intracapsular tonsillectomy, tonsillotomy, tonsillectomy, paediatrics, and sleep disordered breathing.Results:Eighteen papers were identified and reviewed. Subtotal tonsillectomy would appear to have an efficacy equal to that of total tonsillectomy for the treatment of sleep disordered breathing, and has significant benefits in reducing post-operative pain and analgesia use. Subtotal tonsillectomy patients appear to have less frequent post-operative haemorrhage compared with total tonsillectomy patients.Conclusion:In children, subtotal tonsillectomy is associated with fewer post-operative complications whilst having a comparable effect in improving sleep disordered breathing, compared with total tonsillectomy.
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Swain, Santosh Kumar. "Post-tonsillectomy pain management in pediatric patients-a review." International Journal of Contemporary Pediatrics 8, no. 9 (August 23, 2021): 1637. http://dx.doi.org/10.18203/2349-3291.ijcp20213336.
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Tonsillectomy is a common surgical procedure performed in the pediatric age group. Although tonsillectomy is a safe surgery, it is associated with significant post-operative pain. Analgesia after tonsillectomy is often inadequate. Severe post-tonsillectomy throat pain has been described for more than a decade. Parents often worry for handling the pain of their children in home. Post-tonsillectomy pain is often considered as a long lasting and intense in nature. Post-tonsillectomy pain in children is an important problem which overstrains the patient, family and hospital staff. Post-tonsillectomy pain in children is an important problem which overstrains the patient, family and hospital staff. Regulatory alteration in the analgesic armamentarium, particularly in pediatric patients are making the treatment of post-tonsillectomy pain more difficult. Post-tonsillectomy pain in pediatric patients continues to be highly debated clinical issue and also an area of active research. Post-tonsillectomy pain can result in significant morbidity among pediatric patients. There are several analgesics available; each one has its own risk profile and unique side effects when used in pediatric age group in post-tonsillectomy period. This review article provides an update on recent management of post-tonsillectomy pain in pediatric patients. This article reviews the epidemiology, pathophysiology, impact of post-tonsillectomy pain in children and details of medications used for controlling post-tonsillectomy pain.
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Swain, Santosh Kumar. "Current treatment of post-tonsillectomy pain: a review." International Journal of Otorhinolaryngology and Head and Neck Surgery 7, no. 10 (September 27, 2021): 1708. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20213911.
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<p class="abstract">Tonsillectomy is one of the most common surgical procedures performed by an otorhinolaryngologist. This surgery is done more in the pediatric age group. Although tonsillectomy is safe and effective surgery, it is usually associated with significant post-operative pain. Analgesics used for post-tonsillectomy pain is often inadequate. Severe throat pain following tonsillectomy has been documented for decades. Patients or parents/caretakers often worry about such severe pain in the home. The pain following tonsillectomy is usually intense and long-lasting. The severe post-tonsillectomy pain often overstrains the patient, family, and hospital staff. Regular changes in the analgesic armamentarium, particularly in pediatric patients are making the treatment of post-tonsillectomy pain more challenging. Pain following the tonsillectomy period continues to be a highly debated issue and an area of active research. Throat pain in the post-tonsillectomy period can result in significant morbidity among patients. There are different analgesics available; each one has its risk profile and side effects when used for controlling post-tonsillectomy pain. This review article discusses on recent management of post-tonsillectomy pain. This article reviews the epidemiology, pathophysiology, impact of post-tonsillectomy pain, and details of medications used for controlling post-tonsillectomy pain.</p>
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EPURE, Veronica, and Dan Cristian GHEORGHE. "Quinsy tonsillectomy in the management of peritonsillar abcess in children." Romanian Journal of Medical Practice 16, no. 1 (March 31, 2021): 97–100. http://dx.doi.org/10.37897/rjmp.2021.1.17.
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The treatment of peritonsillar abcess in children is controversial: it consists either of immediate drainage followed by interval tonsillectomy, either of immediate tonsillectomy (abcess tonsillectomy or quinsy tonsillectomy). The authors report 3 cases of quinsy tonsillectomy performed in children with peritonsillar abcesses.
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Bhandari, Chhanya, Bibek Sharma, Apar Pokharel, and Naganawalachulu Jayaprakash Mayya. "Intraoperative Blood Loss, Surgical Duration and Postoperative Pain following Cold Dissection Tonsillectomy and Bipolar Electrocautery Tonsillectomy." Journal of College of Medical Sciences-Nepal 17, no. 4 (December 31, 2021): 341–46. http://dx.doi.org/10.3126/jcmsn.v17i4.42212.
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Introduction: Tonsillectomy surgery is one of the common surgeries done in department of ENT and HNS. Over the past two centuries, indications and techniques for performing tonsillectomy has much changed. Several techniques for tonsillectomy are described, but their relative effectiveness still remains a matter of debate. To compare the intraoperative bleeding and post-operative pain following bipolar electrocautery tonsillectomy and cold dissection tonsillectomy. Methods: This prospective randomized study was conducted on 60 tonsillitis patients planned for surgery in College of Medical Sciences, Bharatpur, Chitwan during a period of one year. They were divided into two groups: one undergoing tonsillectomy by use of bipolar electrocautery and the other Cold dissection tonsillectomy by random selection. Intraoperative bleeding and postoperative pain were scored and compared. Results: In this study, the mean blood loss during cold dissection tonsillectomy was 25ml and during bipolar cautery was 12ml. The average operative time was 30 minutes for cold dissection group and 25 minutes for bipolar cautery group. The pain score for Cold dissection tonsillectomy group was significantly significant less when compared with pain scores for bipolar cautery tonsillectomy group. Conclusions: Our study shows that tonsillectomy using bipolar electrocautery causes less blood loss and decreased operative duration than cold steel dissection, however it caused relatively more postoperative pain than cold steel dissection tonsillectomy.
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Erdélyi, Eszter, Gréta Csorba, Beáta Kiss-Fekete, Gabriella Fekete-Szabó, Balázs Sztanó, Ágnes Kiricsi, Zita Zákány, et al. "Tonsillectomia versus tonsillotomia." Orvosi Hetilap 161, no. 45 (November 8, 2020): 1920–26. http://dx.doi.org/10.1556/650.2020.31849.
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Összefoglaló. Bevezetés és célkitűzés: A szerzők a posztoperatív fájdalom és a sebgyógyulás tekintetében prospektív vizsgálattal hasonlították össze gyermekeken (67 fő, 1–12 év) a hagyományos hidegeszközzel történő extracapsularis tonsillectomiát (23 fő) a microdebriderrel (23 fő) és a coblatorral (21 fő) végzett intracapsularis tonsillotomiával. Módszer: A vizsgálatok a betegek által kitöltött kérdőívek, valamint prospektív klinikai adatgyűjtés alapján történtek. Eredmények: Az intracapsularis tonsillotomia gyógyulási idejét 50%-kal rövidebbnek találtuk, és az első 13 napban szignifikánsan kevesebb fájdalommal és fájdalomcsillapító igénnyel járt, mint az extracapsularis tonsillectomia eseteiben. A tonsillotomiás csoporton belül egyedül a posztoperatív első napi fájdalom tekintetében észleltünk szignifikáns különbséget a két különböző módszer között a coblator javára (p<0,05). A vizsgálatokat retrospektív áttekintéssel is kiegészítettük, 4 évi gyermek- (1–15 éves) tonsillaműtéten átesett beteganyagunk (1487 fő) eredményeinek feldolgozásával. Tonsillectomia (1253 fő) után 7,7%-os utóvérzési arányt észleltünk, műtéti vérzéscsillapításra 1,3%-ban volt szükség. Tonsillotomia esetén (234 fő) 0,43%-os utóvérzési arányt regisztráltunk. Ebben a csoportban vérzés miatt nem, de 2 esetben ismételt obstrukciót okozó hypertrophia, 1 esetben góctünetek miatt reoperációt végeztünk (1,28%). Következtetés: Eredményeiket a szerzők a nemzetközi ajánlások tükrében elemezték. Az intracapsularis tonsillotomia kisebb fájdalommal, kisebb vérzéssel és kisebb megterheléssel jár. A közösségbe való aktív visszatérés akár egy hét után lehetséges a tonsillectomiára jellemző 3 héttel szemben, mindez jelentős szocioökonómiai előnyökkel járhat. Orv Hetil. 2020; 161(45): 1920–1926. Summary. Introduction and objective: Examining operated children in this prostective study inditerscompared (67 pts, 1–12 yrs) the extracapsular tonsillectomy with conventional cold-knife (23 pts) to extracapsular tonsillotomy with microdebrider (23 pts) and coblator (21 pts) for postoperative pain and wound-healing disorders. Method: The study was based on patient-completed questionnaires as well as prospective clinical data collection. Results: The recovery time of intracapsular tonsillotomy was found less than 50%, with less pain than in the cases of extracapsular tonsillectomy. Postoperative pain was significantly less in the tonsillototomy group than the tonsillectomy group. Within the tonsillotomy group, a significant difference was observed between the two different methods in favor of the coblator for only the postoperative first-day pain. The studies were supplemented with a retrospective review by processing the 4 yrs results of their pediatric (1–15-yrs) patients who underwent tonsillectomy (1487 pts). After tonsillectomy (1253 pts), a postoperative bleeding rate of 7.7% was observed, and surgical hemostasis was required in 1.3%. In the case of tonsillotomy (234 pts), a postoperative bleeding rate of 0.43% was recorded. In this group, reoperation was not performed due to bleeding, whereas it was neccesary in 2 cases due to hypertrophy causing repeated obstruction, in 1 case due by virtue of focal symptomes (1.28%). Conclusion: Our results were analyzed on the basis of international recommendations. Intracapsular tonsillotomy is associated with less pain, less bleeding, and less strain. Active return to the community is possible after up to a week compared to the 3 weeks typical of tonsillectomy, all of which can have significant socioeconomic benefits. Orv Hetil. 2020; 161(45): 1920–1926.
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Santhraya, Mahesh, and Pallavi Pavithran. "Popular techniques in tonsillectomy: A randomised, controlled study." IP Journal of Otorhinolaryngology and Allied Science 3, no. 4 (January 15, 2021): 126–29. http://dx.doi.org/10.18231/j.ijoas.2020.027.
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Tonsillectomy is one of the commonest operations performed by Otolaryngologists. Various methods of tonsillectomy have been practiced over the century aimed at reducing or eliminating intra-operative and postoperative morbidity. To compare the mean operative time, mean blood loss, post operative pain and complications in tonsillectomy using bipolar cautery and diode laser, versus conventional cold steel dissection tonsillectomy. A prospective, randomised controlled study of 90 patients to compare three tonsillectomy techniques: diode laser, bipolar cautery and classical cold dissection, from May 2016 to October 2019. The operative time, blood loss and pain were significantly lower with tonsillectomy using bipolar cautery and diode laser tonsillectomy than with cold dissection tonsillectomy. Bipolar dissection took the shortest time on an average, whereas blood loss was the least with Diode Laser tonsillectomy. Post operative pain increased in the Laser group by the 5 day. Both bipolar and diode laser tonsillectomy are associated with significantly reduced blood loss, shorter operative times and less post operative pain compared with cold dissection tonsillectomy. But there was no significant difference seen regarding the postoperative pain when comparing both the surgical methods, by the end of one week.
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Sugiura, Natsuki, Kentaro Ochi, Yasushi Komatsuzaki, Hirohito Nishino, and Toru Ohashi. "Postoperative Pain in Tonsillectomy: Comparison of Ultrasonic Tonsillectomy versus Blunt Dissection Tonsillectomy." ORL 64, no. 5 (2002): 339–42. http://dx.doi.org/10.1159/000066082.
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Sunkaraneni, V. S., H. Ismail-Koch, R. J. Salib, and P. K. Jain. "Guillotine tonsillectomy: a neglected technique." Journal of Laryngology & Otology 123, no. 8 (August 2009): 907–9. http://dx.doi.org/10.1017/s002221510900485x.
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AbstractBackground:Increased post-operative tonsillectomy haemorrhage rates have been observed following ‘hot’ tonsillectomy techniques, compared with ‘cold steel’ dissection. Post-tonsillectomy haemorrhage rates and the degree of blood loss during guillotine tonsillectomy have not been reported in the recent literature.Methods:This retrospective case note review assessed the degree of blood loss during guillotine tonsillectomy, as measured by the number of tonsil swabs used, and the post-tonsillectomy haemorrhage rate.Results:In a group of 168 patients, no tonsil swabs were used in 13.1 per cent of cases, and less than two tonsil swabs were used in 41.1 per cent of cases.Conclusion:Guillotine tonsillectomy, when performed by the method described in this article, resulted in minimal intra-operative blood loss in 54 per cent of cases, and appeared to have comparable post-tonsillectomy haemorrhage rates to cold steel dissection techniques.
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Firdaus, Faundra Arieza. "Peritonsillar Block with Triamcinolone as a Preemptive Analgesia in Tonsillectomy with Bipolar Electrocauter." Journal of Anaesthesia and Pain 5, no. 2 (May 31, 2024): 51–54. http://dx.doi.org/10.21776/ub.jap.2024.005.02.05.
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Background: Tonsillectomy is one of the common types of ear, nose, and throat (ENT) surgery. Patients undergoing tonsillectomy frequently experience significant postoperative pain due to oropharyngeal muscle spasms and irritation of afferent nerve fibers. According to previous studies, triamcinolone for peritonsillar block was used to reduce postoperative pain in patients who have undergone tonsillectomy. The aims and objectives of this study were to observe the effectiveness of peritonsillar block using triamcinolone for reducing pain in patients with post-tonsillectomy using the bipolar electrocautery technique. Case: A 34-years-old male patient with chronic tonsillitis and obstructive sleep apnea (OSA) was undergoing tonsillectomy with general anesthesia and peritonsillar block after general anesthesia with triamcinolone 0,5 mg/kg body weight in the right and left fossa peritonsillar. Postoperative hemodynamic monitoring was carried out in the inpatient room. Patients were assessed for pain scale after tonsillectomy and side effects of triamcinolone, with pain indicator using the Wong-baker faces pain rating scale, numeric pain rating scale, and Face, legs, activity, cry and consolability (FLACC) Scale. Pain scales were assessed 1 hour after the tonsillectomy in the recovery room, 3 hours after the tonsillectomy in the inpatient room, 8 hours after the tonsillectomy in the inpatient room, 1 day after the tonsillectomy in the inpatient room, and 2 days after the tonsillectomy by phone. The patient went out of the hospital after 1 day of tonsillectomy. Conclusion: Peritonsillar block with triamcinolone is effective in reducing pain after tonsillectomy and can be the drug of choice when administering peritonsillar block.
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Sasindran, Vivek, Nidhi Mathew, A. K. Shabna, and B. Harikrishan. "Comparison of Coblation Tonsillectomy vs Dissection Tonsillectomy." International Journal of Otolaryngology and Head & Neck Surgery 08, no. 01 (2019): 49–60. http://dx.doi.org/10.4236/ijohns.2019.81006.
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Salam, Md Abdus, Md Mahbub Alam, Rezwan Ahmed, and Md Sultan Mahmud. "Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy." KYAMC Journal 10, no. 1 (May 22, 2019): 21–24. http://dx.doi.org/10.3329/kyamcj.v10i1.41478.
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Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding.
Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence.
Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery.
Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups.
Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method.
KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24
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Belloso, Antonio, A. Chidambaram, P. Morar, and M. S. Timms. "Coblation tonsillectomy versus dissection tonsillectomy: Postoperative hemorrhage." Laryngoscope 113, no. 11 (September 9, 2010): 2010–13. http://dx.doi.org/10.1097/00005537-200311000-00029.
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Pham, Dinh, and Quynh Nguyen. "The full cost of tonsillectomy at Children’s hospital 1 in 2019." Journal of Health and Development Studies 04, no. 03 (September 29, 2021): 95–106. http://dx.doi.org/10.38148/jhds.0403skpt20-016.
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Objective: Determine full cost of tonsillectomy at Children’s Hospital 1 in 2019. Methods: Coss–sectional descriptive study 304 tonsillectomy children at Children’s Hospital 1 in 2019. Results: The study results showed that the cost of tonsillectomy (excluding consultation fees and pre-operation tests) depend on surgery devices. The average cost of cautery tonsillectomy was 1,740, 869 VND (68% direct cost, 32% indirect cost), of the coblator tonsillectomy was 3,610,031 VND 84.58% direct cost, 15.46% indirect cost), and of the plasma peak tonsillectomy one was 3,600,124 VND (84.54% direct cost, 15.46% indirect cost). In 3 surgery methods, the percentage’s cost of drugs, medical disposible items, and operation team were the largest share in direct costs; in indirect costs, the percentage of human management was the highest proportion, followed by the percentage of facility maintenance cost, and the percentage of other regular expenses cost was very low. Conclusion: The average cost of cautery tonsillectomy was 1,740, 869 VND, of the coblator tonsillectomy was 3,610,031 VND, and of the plasma peak tonsillectomy one was 3,600,124 VND.This cost is higher than the current hospital fee the patient or the health insurance paid. This implies a mismatch between input costs and hospital rates. Key words: Tonsillectomy cost, Children’s Hospital 1, cautery, Coblator, Plasma Peak Blade.
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Epure, Veronica, and D. C. Gheorghe. "Myth and reality of tonsillectomy in children?" Romanian Medical Journal 63, no. 3 (September 30, 2016): 205–8. http://dx.doi.org/10.37897/rmj.2016.3.3.
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The authors review tonsillectomy from the patient’s point of view, trying to find answers to some of the most frequently asked questions regarding tonsillectomy: will the child be more prone to respiratory disease or weight gain after tonsillectomy?; is there any age limitation or seasonal variation of risks in tonsillectomy?; will the new surgical methods (i.e. coblation) reduce pain and bleeding risk after tonsillectomy? Materials and method. The authors compare their own clinical cases to cases reviewed from the literature. Conclusion. Tonsillectomy in children remains an important and up-to-date surgical technique, with well known indications and obvious benefits.
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Ragab, S. M. "Six years of evidence-based adult dissection tonsillectomy with ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or ‘cold steel’ dissection." Journal of Laryngology & Otology 126, no. 10 (September 19, 2012): 1056–62. http://dx.doi.org/10.1017/s0022215112002022.
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AbstractObjective:To conduct an adequately powered, prospective, randomised, controlled trial comparing adult dissection tonsillectomy using either ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or ‘cold steel’ dissection.Methods:Three hundred patients were randomised into four tonsillectomy technique groups. The operative time, intra-operative bleeding, post-operative pain, tonsillar fossa healing, return to full diet, return to work and post-operative complications were recorded.Results:The bipolar radiofrequency group had a shorter mean operative time. The mean intra-operative blood loss during bipolar radiofrequency tonsillectomy was significantly less compared with cold dissection and ultrasonic scalpel tonsillectomy. Pain scores were significantly higher after bipolar electrocautery tonsillectomy. Patients undergoing bipolar electrocautery tonsillectomy required significantly more days to return to full diet and work. The bipolar electrocautery group showed significantly reduced tonsillar fossa healing during the first and second post-operative weeks.Conclusion:In this adult series, bipolar radiofrequency tonsillectomy was superior to ultrasonic, bipolar electrocautery and cold dissection tonsillectomies. This method combines the advantages of ‘hot’ and ‘cold’ tonsillectomy.
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Rasheed, Ahmed Muhei. "Does the local application of Platelet-Rich Plasma Reduce Hemorrhage after Tonsillectomy? A Comparative Study." Journal of the Faculty of Medicine Baghdad 65, no. 3 (October 1, 2023): 187–91. http://dx.doi.org/10.32007/jfacmedbagdad.2153.
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Background: Tonsillectomy is one of the most common surgical operations in otolaryngology, post-tonsillectomy hemorrhage is a dangerous complication. Several methods have been used to decrease the rate of post-tonsillectomy hemorrhage, one of these methods, a relatively recent method, is local application of platelet-rich plasma (PRP) to the tonsillar beds. Objectives: To evaluate the role of local application of autologous PRP to the tonsillar beds, at the time of tonsillectomy, in post-tonsillectomy hemorrhage. Patients and methods: A prospective comparative study enrolled 64 patients with ages ranging from 6 to 10 years who underwent tonsillectomy with or without adenoidectomy. In each patient, PRP was applied at the time of tonsillectomy to one tonsillar bed (PRP side), while the other side was used as a control side. So, the total sides were 128 (64 PRP and 64 control sides). The patients were followed-up for 10 days and the outcome measure was the occurrence of post-tonsillectomy hemorrhage on the PRP side versus the control side. The association between the variables was established using chi-square test (X2-test). Results: Thirty-eight patients (59.4%) were males and twenty-six patients (40.6%) were females. Adenotonsillectomy was performed in 35 patients (54.7%), while 29 patients (45.3%) underwent tonsillectomy alone. There was no post-operative hemorrhage from the adenoid beds. Post-tonsillectomy hemorrhage occurred in 1 patient (1.6%) on the PRP side and 3 patients (4.7%) on the control side (P-value=0.31). Conclusions: The local application of autologous PRP to the tonsillar bed only once, at the time of tonsillectomy, is not significantly effective in reducing post-tonsillectomy hemorrhage. Received: Jun. 2023 Accepted: July, 2023 Published: Oct .2023
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Byun, Soo Hwan, Chanyang Min, Yong Bok Kim, Heejin Kim, Sung Hun Kang, Bum Jung Park, Ji Hye Wee, Hyo Geun Choi, and Seok Jin Hong. "Analysis of Chronic Periodontitis in Tonsillectomy Patients: A Longitudinal Follow-Up Study Using a National Health Screening Cohort." Applied Sciences 10, no. 10 (May 25, 2020): 3663. http://dx.doi.org/10.3390/app10103663.
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This study aimed to compare the risk of chronic periodontitis (CP) between participants who underwent tonsillectomy and those who did not (control participants) using a national cohort dataset. Patients who underwent tonsillectomy were selected from a total of 514,866 participants. A control group was included if participants had not undergone tonsillectomy from 2002 to 2015. The number of CP treatments was counted from the date of the tonsillectomy treatment. Patients who underwent tonsillectomy were matched 1:4 with control participants who were categorized based on age, sex, income, and region of residence. Finally, 1044 patients who underwent tonsillectomy were matched 1:4 with 4176 control participants. The adjusted estimated value of the number of post-index date (ID) CP did not reach statistical significance in any post-ID year (each of p > 0.05). In another subgroup analysis according to the number of pre- ID CP, it did not show statistical significance. This study revealed that tonsillectomy was not strongly associated with reducing the risk of CP. Even though the tonsils and periodontium are located adjacently, and tonsillectomy and CP may be related to bacterial inflammation, there was no significant risk of CP in patients undergoing tonsillectomy.
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Koltai, Peter J., C. Arturo Solares, Jeffery A. Koempel, Keiko Hirose, Tom I. Abelson, Paul R. Krakovitz, James Chan, Meng Xu, and Edward J. Mascha. "Intracapsular Tonsillar Reduction (Partial Tonsillectomy): Reviving a Historical Procedure for Obstructive Sleep Disordered Breathing in Children." Otolaryngology–Head and Neck Surgery 129, no. 5 (November 2003): 532–38. http://dx.doi.org/10.1016/s0194-59980300727-7.
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OBJECTIVE: We sought to reintroduce a historical procedure—intracapsular tonsillar reduction (partial tonsillectomy or tonsillotomy)—for tonsillar hypertrophy causing obstructive sleep disordered breathing (OSDB) in children, as well as to determine whether partial tonsillectomy, compared with conventional (total) tonsillectomy when performed by more than one surgeon, is equally effective for the relief of OSDB while resulting in less pain and more rapid recovery. STUDY DESIGN: We conducted a retrospective case series at a tertiary children's hospital. The charts of children who underwent partial tonsillectomy and total tonsillectomy (1998 through 2002) for postoperative complications were reviewed. The caregivers were surveyed to assess postoperative pain, rapidity of recovery, and effectiveness of surgery for relieving symptoms of OSDB. RESULTS: Two hundred forty-three children underwent partial tonsillectomy and 107 children underwent total tonsillectomy. There were no significant differences in immediate and delayed complications between the groups. Both operations were equally effective in relieving OSDB. Children who had partial tonsillectomy had significantly less postoperative pain and significantly more rapid recovery. CONCLUSION: Intracapsular tonsillar reduction with an endoscopic microdebrider relieves OSDB as effectively as conventional tonsillectomy, but results in less postoperative pain and a more rapid recovery.
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Noor, Allah, Muhammad Mudassir, Saadat Ullah Khan, and Shahibzada Fakhar Alam. "Evaluation of Post-Tonsillectomy Complications between the Traditional Cold-Steel Dissection and Electrocautery Methods. A Controlled Randomized Trial." Pakistan Journal of Medical and Health Sciences 17, no. 6 (June 30, 2023): 356–57. http://dx.doi.org/10.53350/pjmhs2023176356.
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Background: One of the most frequent ENT surgical procedures is the tonsillectomy. Comparing electrocautery to the conventional cold-steel dissection technique, it has been indicated that the latter will cause fewer post-tonsillectomy problems. However, there needs to be more randomized controlled studies to compare the two methods. Objectives: This Study's primary goal is to compare the post-tonsillectomy problems caused by the electrocautery technique versus the conventional cold-steel dissection approach. Methods: Between January 2022 and January 2023, this Study was carried out by the department of Ent hmc Peshawar. A prospective randomized controlled trial will include 125 participants in total. Patients will get a tonsillectomy and be randomly allocated to either the electrocautery technique or the conventional cold-steel dissection approach. Pain, bleeding, and infection related to post-tonsillectomy sequelae will be assessed and compared between the two groups. Results: The Study's findings will be utilized to compare the effectiveness and safety of the electrocautery approach versus the conventional cold-steel dissection method for tonsillectomy. Conclusion: This Study will provide otolaryngologists with evidence-based advice on a tonsillectomy procedure. Keywords: tonsillectomy, electrocautery, cold-steel, post-tonsillectomy complications, randomized controlled trial
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Walsh, R. M., B. N. Kumar, A. Tse, P. W. Jones, and P. S. Wilson. "Post-tonsillectomy bacteraemia in children." Journal of Laryngology & Otology 111, no. 10 (October 1997): 950–52. http://dx.doi.org/10.1017/s0022215100139040.
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AbstractIt has been postulated that the bacteraemia rate following guillotine tonsillectomy is lower than that following dissection tonsillectomy due to intra-operative compression of tonsillar blood vessels by the guillotine. The aim of this study was to evaluate the incidence of bacteraemia following dissection and guillotine tonsillectomy. Sixty-four patients undergoing elective tonsillectomy for recurrent acute tonsillitis were randomly selected, 32 underwent dissection tonsillectomy and 32 guillotine tonsillectomy. Positive intra-operative blood cultures were obtained in 16 patients (25 %), nine (28.1 %) of the dissection group and seven (21.8 %) of the guillotine group. There was no significant difference between the two methods (Chi-squared test, p = 0.77).
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Toh, Alex, Annemarie Mullin, Joe Grainger, and Harpreet Uppal. "Indications for Tonsillectomy: Are We Documenting Them?" Annals of The Royal College of Surgeons of England 91, no. 8 (November 2009): 697–99. http://dx.doi.org/10.1308/003588409x12486167521712.
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INTRODUCTION Tonsillectomy is one of the most frequently performed operations in the UK. Documentation of the indications for tonsillectomy is vital, and should fulfil evidence-based guidelines where possible. We present a completed audit, evaluating the documentation of our department's practice in meeting the recommendations made by the Scottish Intercollegiate Guideline Network (SIGN) on indications for tonsillectomy. PATIENTS AND METHODS A prospective audit of 100 children undergoing tonsillectomy for recurrent tonsillitis at a university hospital during two time periods: October 2007 to January 2008 and March to September 2008. Interventions including the production of posters and rubber stamps were agreed and implemented between the two audit periods. RESULTS Following the implementation of simple changes, significant improvements were seen in documentation relating to the SIGN guidelines for tonsillectomy. Overall, the number of children meeting all four SIGN criteria for tonsillectomy rose from 12% to 44% (χ2 = 57.8; P < 0.001). Furthermore, a significant reduction was seen in the number of children below the age of 5 years undergoing tonsillectomy for recurrent tonsillitis (χ2 = 14.66; P < 0.001). CONCLUSIONS With increasing scrutiny on tonsillectomy, it is important to ensure that the reasons for performing tonsillectomy are documented clearly and adhere to evidence-based guidance where possible. We have demonstrated that, with only simple and low-cost interventions, significant improvements in the documentation of tonsillectomy indications can be achieved.
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Gobillot, Theodore A., Azeem S. Kaka, Sapna A. Patel, Cristina Rodriguez, Richard B. Cannon, Neal D. Futran, and Jeffrey J. Houlton. "Treatment of Tonsillar Carcinoma following Nononcologic Tonsillectomy: Efficacy of Transoral Robotic Revision Tonsillectomy." Otolaryngology–Head and Neck Surgery 160, no. 4 (October 2, 2018): 627–34. http://dx.doi.org/10.1177/0194599818802185.
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Objective To evaluate whether transoral robotic surgery (TORS) is a suitable treatment approach for patients diagnosed with tonsillar carcinoma after a standard palatine tonsillectomy. Study Design Retrospective cohort study. Setting Tertiary care medical center. Subjects and Methods Patients who underwent TORS at the University of Washington from 2010 to 2017 (n = 150) were identified. All patients who were diagnosed with tonsillar carcinoma following a nononcologic tonsillectomy and subsequently underwent TORS radical tonsillectomy were included (n = 14). Tumor stage–matched subjects (n = 44) were included who did not undergo standard tonsillectomy prior to TORS. Our primary outcome was final margin status. Secondary outcomes were presence of residual tumor, receipt and dose of postoperative adjuvant therapy, disease-free survival (DFS), and disease-specific survival. Patients with <6 months of follow-up following definitive treatment were excluded from survival analyses. Results Final margin status was clear in all subjects. Residual tumor was not identified in 13 of 14 (92.9%) prior-tonsillectomy subjects following TORS radical tonsillectomy. Seven of 14 (50%) prior-tonsillectomy subjects and 12 of 44 (27.3%) TORS-matched subjects did not require adjuvant therapy due to favorable pathology. Among subjects who received post-TORS radiation therapy (RT) at our institution, RT dose reduction was achieved in 3 of 4 (75%) prior-tonsillectomy subjects and 21 of 24 (87.5%) TORS-matched subjects. Ten of 14 (71.4%) prior-tonsillectomy subjects and 31 of 44 (70.5%) TORS-matched subjects avoided post-TORS chemotherapy. DFS was not significantly different ( P = .87) between prior-tonsillectomy and TORS-matched groups, and no subjects died of related disease. Conclusions Patients diagnosed with tonsillar carcinoma following a prior nononcologic standard palatine tonsillectomy are suitable candidates for revision surgery with TORS radical tonsillectomy.
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Vīksne, Renāta, Karoļina Poļikarpova, and Ksenija Jenbajeva. "Evaluation of Tonsillectomy Patients and Factors Related to Immediate Tonsillectomy." Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. 78, no. 3 (June 1, 2024): 179–84. http://dx.doi.org/10.2478/prolas-2024-0025.
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Abstract A retrospective cohort study was conducted with the aim to characterise tonsillectomy patients and identify factors related to the development of complicated cases of tonsillitis and consecutive immediate tonsillectomies in the Latvian population. The data of 493 patients were analysed. Patients were hospitalised from 1 January 2019 to 30 November 2020, for elective or immediate tonsillectomy due to recurrent tonsillitis, with or without exacerbation and complications. The patients who underwent elective tonsillectomy were younger than those who underwent immediate tonsil-lectomy. Peritonsillar abscess was more common in smokers than in non-smokers (p < 0.001). Smokers had immediate tonsillectomy more often than non-smokers (p < 0.001). Patients who underwent elective tonsillectomy had the shortest period of antibiotic therapy (p < 0.001). Patients who had immediate tonsillectomy had a longer hospitalisation time. Immediate tonsillectomies were associated with patients of older age, smokers, longer hospitalisation, and antibacterial treatment periods. Unilateral peritonsillar abscess was the most common complication of tonsillitis, which resulted in immediate tonsillectomy.
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Vyas, Shifa, Pritosh Sharma, Nitin Sharma, Abhijit Makwana, and V. P. Goyal. "Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes." International Journal of Otorhinolaryngology and Head and Neck Surgery 5, no. 2 (February 23, 2019): 306. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20190492.
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<p class="abstract"><strong>Background:</strong> The objective of this study is to compare operative time, intraoperative bleeding, postoperative pain between coblation and dissection tonsillectomy.</p><p class="abstract"><strong>Methods:</strong> A total of 62 patients who met the inclusion criteria were divided into two groups according to the surgical procedure they went through. Surgical time intraoperative blood loss, postoperative pain, postoperative regaining of activity and any episode of postoperative bleeding were noted in both the groups and compared. </p><p class="abstract"><strong>Results:</strong> Coblation tonsillectomy fared better than dissection tonsillectomy in terms of having less intraoperative blood loss, less postoperative pain. Patients who underwent coblation assisted tonsillectomy also had earlier return to normal activities. Though the time required for coblation tonsillectomy was more than dissection tonsillectomy there were no episodes of postoperative bleeding in subjects who underwent coblation tonsillectomy.</p><p class="abstract"><strong>Conclusions:</strong> Coblation assisted tonsillectomy is a promising new technique for tonsillectomy as patients had less postoperative morbidity mainly pain. The surgical time required could be reduced further with experience.</p>
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Bhattacharyya, Neil, and Lynn J. Kepnes. "Economic Benefit of Tonsillectomy in Adults with Chronic Tonsillitis." Annals of Otology, Rhinology & Laryngology 111, no. 11 (November 2002): 983–88. http://dx.doi.org/10.1177/000348940211101106.
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To determine the economic impact of adult chronic tonsillitis and the economic improvement from adult tonsillectomy, we studied patients who underwent adult tonsillectomy for chronic tonsillitis with the Glasgow Benefit Inventory and a questionnaire for disease severity parameters before and after tonsillectomy. The economic impact of chronic tonsillitis and adult tonsillectomy were computed with a break-even time analysis model. Eighty-three adult patients (average age, 27.3 years) completed the study with an average duration of follow-up of 37.7 months. The patients exhibited a mean improvement in quality of life of +27.54 ± 4.63 after tonsillectomy according to the Glasgow Benefit Inventory. In the 12 months following the procedure, tonsillectomy resulted in yearly mean decreases in number of weeks on antibiotics by 5.9 weeks, number of workdays missed because of tonsillitis by 8.7 days, and physician visits for tonsillitis by 5.3 visits. In considering the medical costs of tonsillectomy only, the break-even point was found to be 12.7 years, whereas considering the overall economic impact of tonsillectomy resulted in a break-even point of 2.3 years after the procedure. We conclude that tonsillectomy results in significant improvement in quality of life, decreases health-care utilization, and diminishes the economic burden of chronic tonsillitis in the adult patient population.
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Ubayasiri, Kishan, Ravi Kothari, Lisha McClelland, and Mriganka De. "Patient Attitudes to Tonsillectomy." International Journal of Family Medicine 2012 (December 24, 2012): 1–5. http://dx.doi.org/10.1155/2012/735684.
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Introduction. Recent changes to primary care trusts’ Procedures of Limited Clinical Value (PLCV) policy mean that otolaryngologists must now follow policy rather than exercising clinical judgment when listing patients for tonsillectomy. Objectives. To gauge perception within the general public of when tonsillectomy is acceptable and to compare this to the current policy. Method. All patients or their parents attending the adult and paediatric outpatient ENT departments were asked to anonymously complete questionnaires. Results. One hundred and twenty-five completed questionnaires were collected. Thirty-one percent of respondents thought tonsillectomy should be offered solely on patient request, 19% after one to three bouts, and 35% after four to six bouts of tonsillitis. Only 9% thought the current guidelines were reasonable. Patients who had suffered recurrent tonsillitis or had undergone previous tonsillectomy generally thought tonsillectomy advisable after more bouts of tonsillitis than those who had not. Fourteen patients fulfilled the SIGN guidelines for tonsillectomy for recurrent tonsillitis. Of these, 13 (93%) felt that suffering 4–6 bouts of tonsillitis was reasonable before tonsillectomy. Conclusion. All patients we surveyed who meet the current PLCV and SIGN guidelines regarding the appropriateness of tonsillectomy for recurrent tonsillitis perceive that they are excessive, believing that 4–6 bouts of recurrent tonsillitis are adequate to justify tonsillectomy.
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Riechelmann, H., E. C. Blassnigg, C. Profanter, K. Greier, F. Kral, and B. Bender. "No association between obesity and post-tonsillectomy haemorrhage." Journal of Laryngology & Otology 128, no. 5 (May 2014): 463–67. http://dx.doi.org/10.1017/s0022215114000863.
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AbstractBackground:The prevalence of overweight and obesity is increasing worldwide. The impact of overweight on post-tonsillectomy haemorrhage rates in children and adults is unclear.Methods:Body mass index and post-tonsillectomy haemorrhage were evaluated in all patients treated with tonsillectomy within one year in a tertiary referral centre. Bleeding episodes were categorised according to the Austrian Tonsil Study.Results:Between June 2011 and June 2012, 300 adults and children underwent tonsillectomy. Post-tonsillectomy haemorrhage occurred in 55 patients. Of those, 29 were type A (history of blood in saliva only, no active bleeding), 15 were type B (active bleeding, treatment under local anaesthesia) and 11 were type C (active bleeding, treatment under general anaesthesia). The return to operating theatre rate was 3.7 per cent. Post-tonsillectomy haemorrhage was more frequent in adolescents and adults than in children. Overweight or obesity was positively correlated with age. Post-tonsillectomy bleeding was recorded in 11.1 per cent of underweight patients, 18.9 per cent of normal weight patients and 18.7 per cent of overweight patients (p = 0.7). Data stratification (according to age and weight) did not alter the post-tonsillectomy bleeding risk (p = 0.8).Conclusion:Overweight or obesity did not increase the risk of post-tonsillectomy haemorrhage in either children or adults.
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Paulson, L. M., C. J. MacArthur, K. B. Beaulieu, J. H. Brockman, and H. A. Milczuk. "Speech Outcomes after Tonsillectomy in Patients with Known Velopharyngeal Insufficiency." International Journal of Otolaryngology 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/912767.
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Introduction. Controversy exists over whether tonsillectomy will affect speech in patients with known velopharyngeal insufficiency (VPI), particularly in those with cleft palate.Methods. All patients seen at the OHSU Doernbecher Children's Hospital VPI clinic between 1997 and 2010 with VPI who underwent tonsillectomy were reviewed. Speech parameters were assessed before and after tonsillectomy. Wilcoxon rank-sum testing was used to evaluate for significance.Results. A total of 46 patients with VPI underwent tonsillectomy during this period. Twenty-three had pre- and postoperative speech evaluation sufficient for analysis. The majority (87%) had a history of cleft palate. Indications for tonsillectomy included obstructive sleep apnea in 11 (48%) and staged tonsillectomy prior to pharyngoplasty in 10 (43%). There was no significant difference between pre- and postoperative speech intelligibility or velopharyngeal competency in this population.Conclusion. In this study, tonsillectomy in patients with VPI did not significantly alter speech intelligibility or velopharyngeal competence.
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Silva, S., M. Ouda, S. Mathanakumara, E. Ridyard, and P. Morar. "Tonsillectomy under threat: auditing the indications for performing tonsillectomy." Journal of Laryngology & Otology 126, no. 6 (April 30, 2012): 609–11. http://dx.doi.org/10.1017/s0022215112000643.
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AbstractBackground:The 2009 McKinsey National Health Service report considered that tonsillectomy was relatively ineffective and often unjustified, and that its frequently could be greatly reduced. ENTUK argued against this, for severe recurrent tonsillitis. This study audited clinical indications for tonsillectomy.Criteria and standards:Current guidelines state that patients with recurrent tonsillitis must have disabling sore throat episodes five or more times per year, and symptoms for at least a year, to justify tonsillectomy.Methods:Seventeen recurrent tonsillitis patients receiving tonsillectomy were audited prospectively. Indications were poorly documented in the referral letter, so surgeons agreed to list specified tonsillectomy criteria when scheduling patients for tonsillectomy. A pro forma reminder was distributed to all clinics, and the next 100 scheduled tonsillectomy patients were audited.Results:In the first audit, all 17 tonsillectomies were justified but only two (11.8 per cent) had documented indications. In the second audit, 85 per cent of patients had all essential criteria, which were documented in the listing letter.Conclusion:Tonsillectomy risks being removed from the UK essential otolaryngological surgical register, risking increased patient morbidity and work absence, despite valid supporting evidence of efficacy for recurrent tonsillitis. All UK otolaryngology units should strictly adhere to the ENTUK and Scottish Intercollegiate Guidelines Network recommendations for tonsillectomy, and should document essential criteria in the listing letter, to strengthen the advocacy argument for tonsillectomy as essential, valid treatment for recurrent tonsillitis.
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Chowdhury, C. R., and M. C. M. Bricknell. "The management of quinsy—a prospective study." Journal of Laryngology & Otology 106, no. 11 (November 1992): 986–88. http://dx.doi.org/10.1017/s002221510012153x.
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AbstractA prospective study for the treatment of quinsy was undertaken between January 1989 and September 1991. This was to determine whether abscess tonsillectomy reduces inpatient stay without increasing operative risk compared to incision and drainage combined with interval tonsillectomy. Fifty-three patients were entered into the study. Twenty-one had abscess tonsillectomy and 32 had incision and drainage. This study showed that there is a 95 per cent probability that abscess tonsillectomy reduces hospital stay by between 2.04 and 4.84 (Student's t test t = 5.01; df = 31, p<0.001) days compared to incision and drainage followed by interval tonsillectomy. This is a significant saving in time and resources. Abscess tonsillectomy reduces patients lost to follow-up, avoids the social inconvenience of a second admission, effectively relieves symptoms, treats a contralateral abscess and is the only method of treating children with a quinsy. We recommend abscess tonsillectomy should be performed for quinsy where expertise and facilities are available.
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Wiltshire, D., M. Cronin, N. Lintern, K. Fraser-Kirk, S. Anderson, R. Barr, D. Bennett, and C. Bond. "The debate continues: a prospective, randomised, single-blind study comparing Coblation and bipolar tonsillectomy techniques." Journal of Laryngology & Otology 132, no. 3 (November 20, 2017): 240–45. http://dx.doi.org/10.1017/s0022215117002328.
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AbstractObjectives:Tonsillectomy is a common procedure with significant post-operative pain. This study was designed to compare post-operative pain, returns to a normal diet and normal activity, and duration of regular analgesic use in Coblation and bipolar tonsillectomy patients.Methods:A total of 137 patients, aged 2–50 years, presenting to a single institution for tonsillectomy or adenotonsillectomy were recruited. Pain level, diet, analgesic use, return to normal activity and haemorrhage data were collected.Results:Coblation tonsillectomy was associated with significantly less pain than bipolar tonsillectomy on post-operative days 1 (p= 0.005), 2 (p= 0.006) and 3 (p= 0.010). Mean pain scores were also significantly lower in the Coblation group (p= 0.039). Coblation patients had a significantly faster return to normal activity than bipolar tonsillectomy patients (p< 0.001).Conclusion:Coblation tonsillectomy is a less painful technique compared to bipolar tonsillectomy in the immediate post-operative period and in the overall post-operative period. This allows a faster return to normal activity and decreased analgesic requirements.
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Davidoss, N. H., R. Eikelboom, P. L. Friedland, and P. L. Santa Maria. "Wound healing after tonsillectomy – a review of the literature." Journal of Laryngology & Otology 132, no. 9 (September 2018): 764–70. http://dx.doi.org/10.1017/s002221511800155x.
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AbstractObjectiveTo summarise the available literature related to wound healing post tonsillectomy, including the stages of healing, experimental models for assessing healing (in animals and humans) and the various factors that affect wound healing.MethodsA search of the English literature was conducted using the Ovid Medline database, with the search terms ‘tonsillectomy’ or ‘tonsil’ and ‘wound healing’. Thirty-one articles that objectively assessed tonsillectomy wound healing were included for analysis.ResultsThe majority of assessments in humans investigating tonsillectomy wound healing involve serial direct clinical examinations of the oral cavity. Many patient and surgical factors have been shown to affect wound healing after tonsillectomy. There is some research to suggest that the administration of adjunctive treatment in the post-operative period may be beneficial to tonsillectomy wound healing.ConclusionWound healing post tonsillectomy has been poorly researched. Having a better understanding of the process of wound healing would allow surgeons to potentially prevent, anticipate and manage complications from the surgery that arise as part of the healing process.
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Morris, S., E. Hassin, and M. Borschmann. "Overnight in-hospital observation following tonsillectomy: retrospective study of post-operative intervention." Journal of Laryngology & Otology 132, no. 1 (November 6, 2017): 46–52. http://dx.doi.org/10.1017/s0022215117002171.
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AbstractObjective:The safety of day-case tonsillectomy is widely documented in the literature; however, there are no evidence-based guidelines recommending patient characteristics that are incompatible with day-case tonsillectomy. This study aimed to identify which patients should be considered unsafe for day-case tonsillectomy based on the likelihood of needing critical intervention.Method:Retrospective review of 2863 tonsillectomy procedures performed at University Hospital Geelong from 1998 to 2014.Results:Of the patients, 7.81 per cent suffered a post-tonsillectomy complication and 4.15 per cent required intervention. The most serious complications, haemorrhage requiring a return to the operating theatre and airway compromise, occurred in 0.56 per cent and 0.11 per cent of patients respectively. The following patient characteristics were significantly associated with poorer outcomes: age of two years or less (p < 0.01), tonsillectomy indicated for neoplasm (p < 0.01) and quinsy (p < 0.05).Conclusion:The authors believe that all elective tonsillectomy patients should be considered for day-case surgery, with the following criteria necessitating overnight observation: age of two years or less; an indication for tonsillectomy of neoplasm or quinsy; and an American Society of Anesthesia score of more than 2.
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James, T. W., B. J. Thomson, D. N. Naumann, and D. S. Stevenson. "Platelet function testing in patients with post-operative tonsillectomy bleeding may be a useful early identifier of inherited platelet function disorders." Journal of Laryngology & Otology 134, no. 10 (October 2020): 882–86. http://dx.doi.org/10.1017/s0022215120002030.
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AbstractBackgroundPost-tonsillectomy bleeding is the most frequent complication of tonsillectomy. Inherited platelet function disorders have an estimated prevalence of 1 per cent. Any association between post-tonsillectomy bleeds and undiagnosed inherited platelet function disorders has not been investigated before.ObjectivesTo assess the prevalence of inherited platelet function disorders in a cohort of post-tonsillectomy bleed patients.MethodsAn observational cohort study was conducted using hospital digital records. Platelet function analyser 100 (‘PFA-100’) closure time was tested on post-tonsillectomy bleed patients who presented to hospital.ResultsBetween 2013 and 2017, 9 of 91 post-tonsillectomy bleed patients who underwent platelet function analyser 100 testing (9.89 per cent) had positive results. Five patients (5.49 per cent) had undiagnosed inherited platelet function disorders. Four patients had false positive results secondary to a non-steroidal anti-inflammatory drug effect (specificity of 95.3 per cent) proven by repeat testing six weeks later, off medication. The false negative rate was 0 per cent.ConclusionThe prevalence of inherited platelet function disorders in our post-tonsillectomy bleed cohort is five-fold higher than in the general population. Platelet function analyser 100 testing when patients present with a post-tonsillectomy bleed allows management of their inherited platelet function disorder.
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Murray, D. P., H. El-Hakim, F. Ahsan, and D. A. Nunez. "Does synchronous nasal surgery increase the risk of post-operative haemorrhage in adult patients undergoing tonsillectomy?" Journal of Laryngology & Otology 117, no. 9 (September 2003): 707–9. http://dx.doi.org/10.1258/002221503322334530.
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Otolaryngologists occasionally perform simultaneous procedures on their patients, the indication being co-existent pathology. This is not a universally accepted practice as some feel that the post-operative morbidity is increased in such patients.Tonsillectomy is a common otolaryngological procedure and the main life-threatening complication, haemorrhage is easily identifiable. This study compares the incidence of post-operative haemorrhage requiring admission in patients undergoing tonsillectomy alone with that in patients undergoing tonsillectomy and nasal surgery.A retrospective study was undertaken of all adult patients undergoing tonsillectomy alone or tonsillectomy and synchronous nasal surgery in Aberdeen Royal Infirmary.Seventy-one patients (34 male) with a mean age of 23 years underwent tonsillectomy and synchronous nasal surgery over a nine-year period 1991–1999. The commonest nasal procedure was reduction of the inferior turbinates (in 48 cases). Three hundred and ninety-eight patients (131 male) with a mean age of 23 years underwent tonsillectomy alone over a nine-month period, July 1998 to April 1999.The incidence of post-tonsillectomy haemorrhage in the synchronous nasal surgery group was 12.7 per cent (9 out of 71) compared with four per cent (16 out of 398) in the tonsillectomy alone group (p <0.01, Chi-squared test). There was no difference in hospital stay between the two groups (mean two days).Synchronous nasal surgery increases the incidence of post-tonsillectomy haemorrhage.
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Oko, Michael O., Ian Ganly, Sean Loughran, W. Andrew Clement, David Young, and Neil K. Geddes. "A Prospective Randomized Single-Blind Trial Comparing Ultrasonic Scalpel Tonsillectomy with Tonsillectomy by Blunt Dissection in a Pediatric Age Group." Otolaryngology–Head and Neck Surgery 133, no. 4 (October 2005): 579–84. http://dx.doi.org/10.1016/j.otohns.2005.08.002.
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OBJECTIVE: To determine if there was a difference in postoperative pain and dietary intake when comparing ultrasonic scalpel (US) with blunt dissection tonsillectomy (BD) in children. STUDY DESIGN AND SETTING: A prospective single-blind randomized controlled trial comparing US and BD tonsillectomy in children aged between 5 and 13 years who undergo tonsillectomy for recurrent acute tonsillitis in a specialized pediatric hospital. RESULTS: One hundred and twenty-two children were enrolled. Ninety-three (76%) patients completed dietary and pain scales. Pain was significantly greater in the US group on postoperative days 1 and 3 ( P = 0.0466, P = 0.0084) and overall ( P = 0.0003). Dietary intake scores were significantly better in the US group on days 1, 5, 7, and 9, however, these scores were inconsistent with dietary intake scores declining in both groups throughout the study. Blood loss was statistically significantly greater in the BD group (33.1 ml vs 3.0 ml, P < 0.0001). There were no significant differences for all other observed outcomes. CONCLUSIONS: US tonsillectomy causes significantly more pain overall and on postoperative days 1 and 3 when compared to BD tonsillectomy. US tonsillectomy causes less intraoperative blood loss, the clinical significance of which is questionable. SIGNIFICANCE: US tonsillectomy appears to cause more postoperative pain than BD tonsillectomy in children aged 5 to 13 years undergoing tonsillectomy for recurrent acute tonsillitis.
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Li, Yan, Qi Wan, Zhixin Lan, Ming Xia, Haiyang Liu, Guochun Chen, Liyu He, Chang Wang, and Hong Liu. "Efficacy and indications of tonsillectomy in patients with IgA nephropathy: a retrospective study." PeerJ 10 (December 5, 2022): e14481. http://dx.doi.org/10.7717/peerj.14481.
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Background The efficacy and indications of tonsillectomy in IgA nephropathy (IgAN) remain uncertain. Methods We performed a retrospective cohort study of 452 patients with primary IgAN, including 226 patients who received tonsillectomy and 226 controls selected by propensity score matching who had never undergone tonsillectomy. Study outcomes were clinical remission defined as negative hematuria and proteinuria on three consecutive visits over a 6-month period, the endpoint defined as end-stage renal disease or an irreversible 100% increase in serum creatinine from the baseline value. In addition, we further analyzed the critical level of proteinuria in the efficacy of tonsillectomy and the correlation between MEST-C score and tonsillectomy. Results Up to December 2019, the follow-up period lasted 46 ± 23 months (12–106 months). Kaplan–Meier and multivariate Cox regression analysis revealed that tonsillectomy was beneficial for clinical remission and renal survival. Whether proteinuria was ≤ 1 g/24h or >1 g/24h, the clinical remission and renal survival rates were greater in patients treated with tonsillectomy than without. When the pathological damage was mild or relatively severe, tonsillectomy may be beneficial to clinical remission or renal survival. Conclusions Tonsillectomy had a favorable effect on clinical remission and delayed renal deterioration in IgAN. In addition to patients with early stage IgAN, it may also be beneficial to IgAN patients with higher levels of proteinuria and relatively severe pathological damage.
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Yildirim, Ilhami, Erdogan Okur, Pinar Ciragil, Mural Aral, M. Akif Kilic, and Mustafa Gul. "Bacteraemia during tonsillectomy." Journal of Laryngology & Otology 117, no. 8 (August 2003): 619–23. http://dx.doi.org/10.1258/002221503768199951.
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The aim of this study was to determine the incidence of bacteraemia during tonsillectomy and investigate the effect of the timing of culture sampling on the incidence of bacteraemia associated with it. Sixty-four consecutive patients who had been admitted for elective tonsillectomy were included in the study. Patients were randomly classified into two groups. Blood cultures as well as tonsillar surface and deep tissue cultures were obtained from all patients before tonsillectomy and 60 minutes after tonsillectomy. In addition, blood cultures were taken within two minutes following tonsillectomy for group 1 and 15 minutes after tonsillectomy for group 2. In group 1, the cultures obtained within two minutes were positive in nine patients, while only two of the blood cultures taken post-operatively were positive in group 2. The difference between the two groups was statistically significant (p < 0.05). The results of this study suggest that a transient bacteraemia occurs frequently in association withtonsillectomy, but the timing of culture sampling for its detection is important.
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Racic, G., D. Kurtovic, Z. Colovic, Z. Dogas, G. Kardum, and Z. Roje. "Influence of meteorological conditions on post-tonsillectomy haemorrhage." Journal of Laryngology & Otology 122, no. 12 (March 20, 2008): 1330–34. http://dx.doi.org/10.1017/s0022215108002053.
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AbstractAim:To evaluate the relationship between the incidence of primary post-tonsillectomy haemorrhage and the daily weather condition, over a five-year period.Study design and setting:This was a retrospective study carried out in the ENT department of the Split University Hospital between January 2000 and December 2004.Results:Out of 3377 patients undergoing tonsillectomy, primary post-operative haemorrhage occurred in 83 (2.5 per cent). The season, daily atmospheric pressure and daily change in atmospheric pressure did not have any significant influence on post-tonsillectomy haemorrhage incidence. However, there was a statistically significant increase in the incidence of primary post-operative haemorrhage when cyclonic conditions prevailed (p = 0.035).Conclusion:The incidence of primary post-tonsillectomy haemorrhage in our study population was 2.5 per cent. Avoiding tonsillectomy during cyclonic weather conditions may reduce the incidence of primary post-tonsillectomy haemorrhage.