Complications and legal outcomes of tonsillectomy malpractice claims

Stevenson, Andrew N.; Myer, Charles M.; Shuler, Matthew D.; Singer, Peter S.

doi:10.1002/lary.22438

Cited by 40 publications

(42 citation statements)

References 28 publications

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“…This is consistent with other study [63]. The rate of post operative bleeding of 2.88% in the present study was in agreement to the rate of 2.4% found in other studies [64].…”

Section: Discussionsupporting

confidence: 94%

Allergic rhinitis and its associated co-morbidities at Bugando Medical Centre in Northwestern Tanzania; A prospective review of 190 cases

Said

Mchembe

Chalya

et al. 2012

BMC Ear Nose Throat Disord

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BackgroundAllergic rhinitis is one of the commonest atopic diseases which contribute to significant morbidity world wide while its epidemiology in Tanzania remains sparse. There was paucity of information regarding allergic rhinitis in our setting; therefore it was important to conduct this study to describe our experience on allergic rhinitis, associated co-morbidities and treatment outcome in patients attending Bugando Medical Centre.MethodsThis was descriptive cross-sectional study involving all patients with a clinical diagnosis of allergic rhinitis at Bugando Medical Centre over a three-month period between June 2011 and August 2011. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 17.0.ResultsA total of 190 patients were studied giving the prevalence of allergic rhinitis 14.7%. The median age of the patients was 8.5 years. The male to female ratio was 1:1. Adenoid hypertrophy, tonsillitis, hypertrophy of inferior turbinate, nasal polyps, otitis media and sinusitis were the most common co-morbidities affecting 92.6% of cases and were the major reason for attending hospital services. Sleep disturbance was common in children with adenoids hypertrophy (χ2 = 28.691, P = 0.000). Allergic conjunctivitis was found in 51.9%. The most common identified triggers were dust, strong perfume odors and cold weather (P < 0.05). Strong perfume odors affect female than males (χ2 = 4.583, P = 0.032). In this study family history of allergic rhinitis was not a significant risk factor (P =0.423). The majority of patients (68.8%) were treated surgically for allergic rhinitis co morbidities. Post operative complication and mortality rates were 2.9% and 1.6% respectively. The overall median duration of hospital stay of in-patients was 3 days (2 – 28 days). Most patients (98.4%) had satisfactory results at discharge.ConclusionThe study shows that allergic rhinitis is common in our settings representing 14.7% of all otorhinolaryngology and commonly affecting children and adolescent. Sufferers seek medical services due to co-morbidities of which combination of surgical and medical treatment was needed. High index of suspicions in diagnosing allergic rhinitis and early treatment is recommended.

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“…This is consistent with other study [63]. The rate of post operative bleeding of 2.88% in the present study was in agreement to the rate of 2.4% found in other studies [64].…”

Section: Discussionsupporting

confidence: 94%

Allergic rhinitis and its associated co-morbidities at Bugando Medical Centre in Northwestern Tanzania; A prospective review of 190 cases

Said

Mchembe

Chalya

et al. 2012

BMC Ear Nose Throat Disord

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“…(4) Complications are often underreported by surgeons (fear of being reprimanded or litigation) or journals (considered uninteresting). This statement is supported by the surprisingly high number of litigations resulting from tonsillectomy [22,23] which is not mirrored by an adequate amount of reports in the medical literature. (5) There is no uniformly accepted method of performing tonsillectomy.…”

Section: Discussionmentioning

confidence: 64%

Serious Complications following Tonsillectomy: How Frequent Are They Really?

Windfuhr¹

2013

ORL

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Introduction: Quality assurance in health care involves the evaluation of outcomes, cost-benefit ratios, and access to the delivery system. This literature review was undertaken to clarify the incidence of serious posttonsillectomy complications to better understand the outcome component of quality assurance. Material and Methods: A Medline review was undertaken using the key word ‘tonsillectomy' AND each of the following: ‘serious', ‘complications' and ‘review'; ‘meta-analysis', ‘Cochrane'; ‘life-threatening', ‘death' and ‘disability'. Results: 454 articles were identified with the following search items in combination with ‘tonsillectomy': ‘serious' (154), ‘complications', ‘review' (24), ‘meta-analysis' (38), ‘Cochrane' (43), ‘life-threatening' (87), ‘death' (91), ‘disability' (17). Sixty-seven articles described a complication rate and were therefore eligible for review: 22 case reports, 9 case series, 2 questionnaires and 33 studies with a more or less precise complication rate were obtainable. Most articles (n = 30) reported the rate of posttonsillectomy hemorrhage with a considerable range. Fifteen articles reported the incidence of death, which ranged from 1:7,132 to 1:170,000 and almost always resulted from excessive hemorrhage. All other complications were mentioned in case reports. Conclusion: The most common postoperative complication of tonsillectomy is bleeding. However, the incidence varies considerably across studies depending on the study design, follow-up and definition of postoperative bleeding. Other serious adverse events, such as neurological disabilities, emphysema (with or without pneumomediastinum), or vascular problems outside the neck are infrequent.

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“…3,21,29,35,37 Mortality rates of AT have been estimated between 1 in 16 000 and 1 in 35 000 cases. 42 Nixon et al 22 demonstrated that sleep-related airway obstruction is a common postoperative complication leading to significant oxyhemoglobin desaturations after AT in children with severe OSA. Episodes of desaturation occurred during the first postoperative night in all 10 children studied, and these desaturation episodes were predominantly caused by upper airway obstruction.…”

Section: Figurementioning

confidence: 99%

Adenotonsillectomy Complications: A Meta-analysis

et al. 2015

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BACKGROUND AND OBJECTIVE: Complications after adenotonsillectomy (AT) in children have been extensively studied, but differences between children with and without obstructive sleep apnea (OSA) have not been systematically reported. Our objective was to identify the most frequent complications after AT, and evaluate if differences between children with and without OSA exist.METHODS: Several electronic databases were searched. A partial gray literature search was undertaken by using Google Scholar. Experts were consulted to identify any missing publications. Studies assessing complications after AT in otherwise healthy children were included. One author collected the required information from the selected articles. A second author crosschecked the collected information and confirmed its accuracy. Most of the selected studies collected information from medical charts.RESULTS: A total of 1254 studies were initially identified. Only 23 articles remained after a 2-step selection process. The most frequent complication was respiratory compromise (9.4%), followed by secondary hemorrhage (2.6%). Four studies compared postoperative complications in children with and without OSA, and revealed that children with OSA have nearly 5 times more respiratory complications after AT than children without OSA (odds ratio = 4.90; 95% confidence interval: 2.38-10.10). In contrast, children with OSA are less likely to have postoperative bleeding when compared with children without OSA (odds ratio = 0.41; 95% confidence interval: 0.23-0.74). CONCLUSIONS:The most frequent early complications after AT are respiratory compromise and secondary hemorrhage. Based on the current limited evidence, children with OSA appear to have more respiratory complications. Conversely, hemorrhage appears to be more frequent in children without OSA.

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Complications and legal outcomes of tonsillectomy malpractice claims

Cited by 40 publications

References 28 publications

Allergic rhinitis and its associated co-morbidities at Bugando Medical Centre in Northwestern Tanzania; A prospective review of 190 cases

Allergic rhinitis and its associated co-morbidities at Bugando Medical Centre in Northwestern Tanzania; A prospective review of 190 cases

Serious Complications following Tonsillectomy: How Frequent Are They Really?

Adenotonsillectomy Complications: A Meta-analysis

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