Wound healing after tonsillectomy – a review of the literature

Davidoss, Nishant Hemanth; Eikelboom, Robert H.; Friedland, Peter; Maria, Peter L. Santa

doi:10.1017/s002221511800155x

Cited by 26 publications

(29 citation statements)

References 47 publications

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“…It is worth noting that the mean time to occur secondary bleeding was 7.8th days after surgery in the three groups. As epithelial cells grow inward from the wound edge, the epithelial contracture causes the fibrinous clot to separate and expose the granulation tissue on the 7th day after surgery (9). Meantime, as patient's pain getting greatly reduced, patients are eager to return to a normal diet, subconscious mechanical stretching is more likely to cause secondary bleeding.…”

Section: Discussionmentioning

confidence: 99%

Comparison Of Harmonic Scalpel, Coblation And Cold Dissection For Tonsillectomy In Adult

Cui

Sun

2021

Preprint

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Objectives: To compare the safety and effectiveness of tonsillectomy with three different techniques. Design: A double-blinded randomized prospective clinical trial Setting and Participants: Totally120 patients with recurrent tonsillitis between April 2018 and April 2020 were included. Main Outcome Measures: Operative time, intra and post operative bleeding loss, pseudomembrane growth time, pseudomembrane shedding time, postoperative pain, and necrosis depth of specimens were compared of harmonic scalpel(HS), coblation and cold dissection(CD) tonsillectomy. Results: The operative time and intraoperative bleeding loss was significantly less in HS and coblation group than CD group(p < 0.05). Pseudomembrane growth time and pseudomembrane shedding time were significantly longer in the HS group compared with the other groups(p < 0.05). The postoperative pain levels were significantly higher on the first postoperative day in CD group(p < 0.05), and significantly lower on the third and seventh postoperative day in coblation group(p < 0.05). There was no significant difference among three techniques in terms of postoperative bleeding loss(p > 0.05). The deepest necrosis depth in specimen was found in HS group(p > 0.05), while in CD group, only edema was observed without necrosis. Conclusion: To compared with HS and CD, coblation is a faster, safer and more painless technique for tonsillectomy in adult.

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Section: Discussionmentioning

confidence: 99%

Comparison Of Harmonic Scalpel, Coblation And Cold Dissection For Tonsillectomy In Adult

Cui

Sun

2021

Preprint

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“…The postoperative period was divided into four phases according to patient discharge schedule and the stages of wound healing [ 20 , 21 ]: 0–24 h post surgery, 1–3 days, 4–10 days, and the period after the 10 th postoperative day.…”

Section: Methodsmentioning

confidence: 99%

Temporal fluctuations of post-tonsillectomy haemorrhage

Grasl

Mekhail

Janik

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Although haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhage (PTH) and potential ramifications to educate patients and health care staff. Methods This retrospective study carried out at a tertiary referral hospital included paediatric and adult patients requiring emergency surgery due to severe PTH between 1993 and 2019. Medical records were reviewed and patient demographics, details regarding the initial procedure, postoperative day of haemorrhage, and start time of emergency surgery were extracted. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney U test, and Chi-square goodness of fit tests were used to detect potential differences. Results A total of 300 patients with severe PTH and subsequent emergency surgery were identified. The median postoperative duration until PTH was 6 (range: < 1–19) days. 64.7% (n = 194) of all emergency surgeries had to be performed during evening and night hours (6 pm—6 am) (p < 0.0001). Compared to diurnal incidents, the risk of a nocturnal PTH event increased, the longer ago the initial surgery was (p < 0.0001). No seasonal variations were identified. Age, sex, and details of the initial procedure had no significant influence on the start time according to the surgical protocol. Conclusion The discovered temporal fluctuations of PTH are of relevance for patient awareness and preoperative education. Due to possible life-threatening complications, management of severe PTH requires specific resources and trained medical staff on call.

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“…Regarding wound healing after adenotonsillectomy, the tonsil fossae are covered with inflammatory exudates after tonsil removal, followed by the gradual replacement of the inflammatory debris and ingrowth of granulation tissue during the second week of recovery (Davidoss et al, 2018;Wexler, 1996). Additionally, the unification of the anterior and posterior pillars is often observed during the follow-up period.…”

Section: Introductionmentioning

confidence: 99%

Positional changes in the uvula tip after adenotonsillectomy in children: preliminary result

Chang

Song

Kim

et al. 2021

PeerJ

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Background Adenotonsillectomy has become the primary treatment for children with sleep-disordered breathing or obstructive sleep apnea. However, few studies have investigated positional changes in the soft palate or uvula after adenotonsillectomy in children. The present study aimed to evaluate positional changes in the uvula tip using cephalometric analyses after adenotonsillectomy in children. Methods We analyzed 160 pediatric patients from December 2015 to July 2016, with 94 pediatric patients who underwent adenotonsillectomy as the experimental group and 66 children who were treated and followed up with frequent tonsillitis as the control group. Positional changes in the uvula tip after surgery in the adenotonsillectomy group were investigated using lateral cephalograms obtained within 1 month before surgery and 3–4 months after surgery. Two lateral cephalogram intervals for a few months in the control group who did not undergo adenotonsillectomy were analyzed. Results The palatal length (23.92 ± 3.47 vs. 24.46 ± 3.26; p = 0.032), palatal angle (43.13 ± 7.76 vs. 46.12 ± 5.91; p < 0.001), and retrouvula length (15.60 ± 3.51 vs. 16.60 ± 2.97; p = 0.009) were significantly increased on postoperative images relative to those on preoperative images. In the control group, there was a significant change in the palatal angle (2.99 ± 5.85 vs. 0.27 ± 4.14; p < 0.001) and retrouvula length (0.99 ± 3.64 vs. 0.05 ± 1.44; p = 0.025), but not in the palatal length (0.58 ± 2.38 vs. 0.043 ± 1.26; p = 0.065). Conclusion The findings of the present study suggest that the uvula tip is displaced in the anteroinferior direction 3 or 4 months after adenotonsillectomy in children. Thus, clinicians should be aware that the retropalatal space may expand after adenotonsillectomy in the pediatric population.

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Wound healing after tonsillectomy – a review of the literature

Cited by 26 publications

References 47 publications

Comparison Of Harmonic Scalpel, Coblation And Cold Dissection For Tonsillectomy In Adult

Comparison Of Harmonic Scalpel, Coblation And Cold Dissection For Tonsillectomy In Adult

Temporal fluctuations of post-tonsillectomy haemorrhage

Positional changes in the uvula tip after adenotonsillectomy in children: preliminary result

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