Tonsillectomy in adults: Analysis of indications and complications

Torres, Blanca; García, Félix de Miguel; Orozco, Jaime Whyte

doi:10.1016/j.anl.2017.08.012

Cited by 34 publications

(32 citation statements)

References 16 publications

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“…The proportion of PTH grades in this study was 21.8% for Grade 1‐3 and 1.5% for Grade 3. Previous studies found that overall PTH incidence ranged from 2.2 to 10%, and PTH was treated surgically in 1 to 6% of cases 17,30,35 . We observed a slightly higher rate of overall PTH than in previous studies.…”

Section: Discussioncontrasting

confidence: 62%

“…Previous studies found that overall PTH incidence ranged from 2.2 to 10%, and PTH was treated surgically in 1 to 6% of cases. 17,30,35 We observed a slightly higher rate of overall PTH than in previous studies. Regarding the management of perioperative term, patients with tonsillectomy are admitted for about 1 week in Japan whereas most patients are admitted for only a few days in other countries.…”

Section: Several Reports Support This Hypothesis Kim Et Al Demonstracontrasting

confidence: 66%

“…Criteria (2) and 3 Age, sex, obesity (BMI ≥ 25), smoking status, operative time, oral antibiotics after surgery, and types of analgesics were analyzed as the risk factors, as suggested by previous research. [15][16][17][18] Smoking status was categorized into never smokers, current smokers (smoking until surgery), and ex-smokers (stopped smoking before surgery). Exsmokers were defined as patients who had a smoking history but stopped smoking at least 1 month prior to surgery.…”

Section: Methodsmentioning

confidence: 99%

“…Regarding the management of perioperative term, patients with tonsillectomy are admitted for about 1 week in Japan whereas most patients are admitted for only a few days in other countries. 17,30 Patients with minor hemorrhage and spontaneous hemostasis may not be monitored by medical personnel. Thus, bleeding cases may have been underestimated in previous research.…”

Section: Several Reports Support This Hypothesis Kim Et Al Demonstramentioning

confidence: 99%

“…15,16 The rate of primary hemorrhage was 11.3% of PTH patients in this study, compared with 9.0% to 22.6% in prior studies, so that our study demonstrated the similar proportions of primary and secondary hemorrhage. 16,17,36,37 The limitation of this study was that we did not investigate other risk factors reported in previous studies, such as the use of power devices (ie, hot instrument vs cold surgery), the modality of devices, 38 other patient characteristics such as hypertension and diabetes mellitus which were not included in our study design, and the experience of the otolaryngologist. 8,9,39 Therefore, such associations may not be represented in our study.…”

Section: Several Reports Support This Hypothesis Kim Et Al Demonstramentioning

confidence: 99%

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Risk factors of post‐tonsillectomy hemorrhage in adults

Inuzuka

Mizutari

Kamide

et al. 2020

Laryngoscope Investig Oto

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Objective: Tonsillectomy is an essential surgery and is conducted on both children and adults. However, the risk factors of post-tonsillectomy hemorrhage for adult patients remain unclear. In this study, we analyzed post-tonsillectomy hemorrhage in adult patients. Methods: We retrospectively analyzed 325 adult patients who underwent a tonsillectomy between 2014 and 2018 in our facilities. Results: The average age of this study's population was 31.7 ± 10.5 years (range: 19-70 years), and 250 (76.9%) patients were male. Overall, post-tonsillectomy hemorrhage occurred in 71 (21.8%) patients and 5 (1.5%) patients required a second surgery for hemostasis. Post-tonsillectomy hemorrhage often occurred on postoperative day zero or six. Using multiple logistic regression analysis, current smoking status (odds ratio 3.491; 95% confidence interval 1.813-6.723), male sex (odds ratio 3.924; 95% confidence interval 1.548-9.944), and perioperative non-steroidal antiinflammatory drug administration (odds ratio 7.930; 95% confidence interval 1.004-62.64) were revealed as overall post-tonsillectomy hemorrhage risk factors. To analyze the hemorrhage period after tonsillectomy, we categorized the posttonsillectomy hemorrhage patients into the primary (bleeding within postoperative day one) and secondary hemorrhage (bleeding on or after postoperative day two) groups. The current smoking status and older age were risk factors for primary hemorrhage and the current smoking status and sex (male) were risk factors for secondary hemorrhage. Conclusions: In this study, smoking status, sex, and perioperative non-steroidal antiinflammatory drug administration were the clinical risk factors for adult posttonsillectomy hemorrhage. Thus, smoking cessation is, at least, mandatory for patients who receive tonsillectomy to avoid post-tonsillectomy hemorrhage.

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Section: Discussioncontrasting

confidence: 62%

Section: Several Reports Support This Hypothesis Kim Et Al Demonstracontrasting

confidence: 66%

Section: Methodsmentioning

confidence: 99%

Section: Several Reports Support This Hypothesis Kim Et Al Demonstramentioning

confidence: 99%

Section: Several Reports Support This Hypothesis Kim Et Al Demonstramentioning

confidence: 99%

See 3 more Smart Citations

Risk factors of post‐tonsillectomy hemorrhage in adults

Inuzuka

Mizutari

Kamide

et al. 2020

Laryngoscope Investig Oto

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Tonsillectomy and social media: An investigative analysis of educational tonsillectomy content on TikTok

John

Gupta

Jhaveri

et al. 2022

Health Science Reports

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Investigation of Adult Post‐Tonsillectomy Hemorrhage Rates and the Impact of NSAID Use

et al. 2021

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Objectives/Hypothesis Tonsillectomy is one of the most common ambulatory surgeries performed in the United States, yet the incidence of post‐tonsillectomy hemorrhage (PTH) in adults remains unclear. In addition, any association between non‐steroidal anti‐inflammatory drugs (NSAIDs) and PTH in adults is currently unknown. The aim of this study is to examine the incidence and management of adult PTH at a single academic center and to assess for any association between NSAID use and PTH in adults. Study Design Retrospective chart review. Methods We conducted a retrospective chart review of adult tonsillectomies performed at our institution between January 1, 2012, and December 30, 2019. Demographics, past medical history, medications, NSAID use, surgical indication, bleeding events, and interventions were documented. The rate of PTH was calculated, logistic regression was performed to assess for any predictive factors, and odds ratios were calculated for NSAID use and PTH. Results A total of 1,057 adult tonsillectomies were performed within the aforementioned time period. A total of 126 patients experienced 163 bleeding events for a postoperative hemorrhage rate of 11.9%. Most were controlled with bedside interventions, while 29 (23%) bled more than once. The hemorrhage rate for those who were not prescribed NSAIDs postoperatively (n = 625) was 11.7%, compared to 12.6% for those who did receive NSAIDs postoperatively (n = 432), which was not significantly different (adjusted odds ratio 1.01, 95% confidence interval 0.69–1.49; P = .95). Conclusions This retrospective cohort study of 1,057 adult patients found the incidence of PTH to be 11.9%. This study found no association between the use of NSAIDs and the rate of PTH, although a higher‐powered study is needed. Level of Evidence 3 Laryngoscope, 132:949–953, 2022

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Tonsillectomy in adults: Analysis of indications and complications

Cited by 34 publications

References 16 publications

Risk factors of post‐tonsillectomy hemorrhage in adults

Risk factors of post‐tonsillectomy hemorrhage in adults

Tonsillectomy and social media: An investigative analysis of educational tonsillectomy content on TikTok

Investigation of Adult Post‐Tonsillectomy Hemorrhage Rates and the Impact of NSAID Use

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