Our Summary

This research paper looks at post-surgery bleeding, which is a common issue that can lead to serious health problems or even death for patients who have had their tonsils removed. The authors suggest that applying certain biological materials during surgery could potentially speed up the healing of the wound in the mouth and eliminate the risk of this dangerous bleeding. To find out what the best biological materials could be, the authors reviewed current materials being used to prevent this bleeding. They also looked at other potential materials that could be used.

FAQs

  1. What is post-tonsillectomy hemorrhage (PTH) and how common is it?
  2. How can the application of biomaterials at the time of tonsillectomy help in preventing PTH?
  3. What are some potential alternative topical biomaterials that can be used to reduce the risk of PTH?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tonsillectomy is to follow all post-operative care instructions carefully, including avoiding strenuous activities, staying hydrated, and taking prescribed pain medication as directed. It is also important to watch for signs of postoperative hemorrhage, such as excessive bleeding or difficulty breathing, and to seek medical attention immediately if these symptoms occur.

Suitable For

Patients who are typically recommended for tonsillectomy include those with:

  1. Recurrent or chronic tonsillitis: Patients who experience frequent episodes of tonsillitis that do not respond to antibiotic treatment may be recommended for tonsillectomy.

  2. Obstructive sleep apnea: Tonsillectomy may be recommended for patients with obstructive sleep apnea caused by enlarged tonsils, especially in children.

  3. Tonsillar hypertrophy: Enlarged tonsils that cause difficulty swallowing, breathing, or speaking may warrant a tonsillectomy.

  4. Tonsil stones: Patients who experience recurrent tonsil stones that cause discomfort or bad breath may be candidates for tonsillectomy.

  5. Tonsil cancer: In cases of tonsil cancer, surgical removal of the affected tonsil(s) may be recommended as part of treatment.

  6. Peritonsillar abscess: Patients with a peritonsillar abscess that does not respond to drainage or antibiotic treatment may require a tonsillectomy.

  7. Recurrent strep throat: Patients who experience multiple episodes of strep throat within a year may be considered for tonsillectomy.

It is important for patients to consult with an otolaryngologist (ear, nose, and throat specialist) to determine if tonsillectomy is the most appropriate treatment option for their specific condition.

Timeline

Before tonsillectomy:

  1. Patient experiences recurrent tonsillitis or other tonsil-related issues, leading to a decision to undergo tonsillectomy.
  2. Consultation with an ENT specialist to discuss the procedure, risks, and benefits.
  3. Pre-operative assessments and tests are conducted to ensure the patient is fit for surgery.
  4. Patient is instructed on pre-operative guidelines, such as fasting before surgery.

After tonsillectomy:

  1. Patient undergoes the surgical procedure to remove the tonsils.
  2. Patient is monitored in the recovery room before being discharged home.
  3. Patient experiences pain and discomfort in the throat, which can be managed with pain medications.
  4. Patient is advised to stick to a soft diet and stay hydrated.
  5. Patient may experience some bleeding in the days following surgery, which is normal to some extent.
  6. Complete healing of the surgical site usually takes around 1-2 weeks.
  7. Follow-up appointments with the ENT specialist may be scheduled to monitor the healing process.
  8. Patient gradually resumes normal activities and diet as advised by the healthcare provider.

What to Ask Your Doctor

  1. What specific biomaterials or techniques do you use to help prevent post-tonsillectomy hemorrhage?

  2. How do these biomaterials work to accelerate mucosal wound healing and reduce the risk of post-tonsillectomy hemorrhage?

  3. Are there any potential side effects or complications associated with the use of these biomaterials during tonsillectomy?

  4. Are there any specific instructions or precautions I should follow after the tonsillectomy to ensure the biomaterials are effective in preventing post-tonsillectomy hemorrhage?

  5. How successful have you been in preventing post-tonsillectomy hemorrhage using these biomaterials in your previous patients?

  6. Are there any alternative topical biomaterials or techniques that could be used to reduce the risk of post-tonsillectomy hemorrhage, and if so, what are the pros and cons of each option?

  7. How soon after the tonsillectomy can I expect to see the benefits of the biomaterials in terms of accelerated wound healing and reduced risk of post-tonsillectomy hemorrhage?

  8. What is the likelihood of experiencing post-tonsillectomy hemorrhage if I choose not to use any topical biomaterials during the surgery?

  9. Are there any specific factors about my medical history or condition that may affect the effectiveness of these biomaterials in preventing post-tonsillectomy hemorrhage?

  10. How frequently will I need to follow up with you after the tonsillectomy to monitor for any signs of post-tonsillectomy hemorrhage or complications related to the use of biomaterials?

Reference

Authors: Liu L, Rodman C, Worobetz NE, Johnson J, Elmaraghy C, Chiang T. Journal: J Otolaryngol Head Neck Surg. 2019 Sep 6;48(1):45. doi: 10.1186/s40463-019-0368-1. PMID: 31492172