Our Summary

This research paper discusses the risks of bleeding (also known as hemorrhage) after a tonsillectomy, a common surgical procedure to remove the tonsils. The risk of bleeding after this procedure is usually around 5%, but severe bleeding is very rare. Various surgical techniques and tools to stop bleeding have been used to lower this risk, but none of them can completely eliminate it. The paper also looks into different factors that may be linked to bleeding after a tonsillectomy. It finds that the patient’s age and any blood clotting disorders they might have are the most common risk factors. The skill of the surgeon and the surgical technique used are most commonly associated with immediate bleeding after the procedure.

FAQs

  1. What is the risk of posttonsillectomy hemorrhage (PTH) and what causes it?
  2. What are the most consistent risk factors for PTH?
  3. What surgical techniques and hemostatic agents have been used to reduce hemorrhage rates in tonsillectomies?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tonsillectomy is to follow postoperative care instructions carefully, including taking prescribed pain medication, staying hydrated, and avoiding strenuous activities. It is also important to watch out for signs of complications such as excessive bleeding, fever, or difficulty breathing, and to seek medical attention if any of these occur. Additionally, it is important to attend all follow-up appointments with the doctor to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for tonsillectomy include:

  1. Recurrent tonsillitis: Patients who have frequent episodes of tonsillitis, typically defined as at least seven episodes in one year, may be recommended for tonsillectomy to prevent further infections.

  2. Enlarged tonsils: Patients with enlarged tonsils that cause difficulty breathing, swallowing, or sleeping may benefit from tonsillectomy to improve their quality of life.

  3. Obstructive sleep apnea: Patients with obstructive sleep apnea due to enlarged tonsils may be recommended for tonsillectomy to improve their breathing and sleep patterns.

  4. Tonsil stones: Patients who frequently experience tonsil stones, which are small, hard masses that form in the tonsils, may be recommended for tonsillectomy to prevent further stones from forming.

  5. Chronic sore throat: Patients who suffer from chronic sore throat that does not improve with conservative treatment may be recommended for tonsillectomy to alleviate their symptoms.

  6. Cancerous or precancerous lesions: In rare cases, patients with cancerous or precancerous lesions on the tonsils may be recommended for tonsillectomy as part of their treatment plan.

It is important for patients to discuss their symptoms and medical history with their healthcare provider to determine if tonsillectomy is the appropriate treatment option for them.

Timeline

Before tonsillectomy:

  1. Patient consults with an otolaryngologist and discusses symptoms and medical history.
  2. Patient undergoes preoperative testing, such as blood work and a physical exam.
  3. Patient is advised on preoperative instructions, such as fasting before surgery.

After tonsillectomy:

  1. Patient is monitored in the recovery room for a few hours following surgery.
  2. Patient may experience throat pain, difficulty swallowing, and ear pain in the days following surgery.
  3. Patient is instructed on postoperative care, such as pain management, hydration, and diet restrictions.
  4. Patient may need to take time off work or school to recover.
  5. Follow-up appointments are scheduled to monitor healing and address any complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a tonsillectomy?

  2. What is the likelihood of posttonsillectomy hemorrhage (PTH) occurring in my case?

  3. Are there any factors that may increase my risk of PTH?

  4. What steps will be taken during the surgery to minimize the risk of PTH?

  5. What should I expect in terms of pain and recovery after the procedure?

  6. How long will it take for me to fully recover from a tonsillectomy?

  7. Are there any specific postoperative care instructions I should follow to reduce the risk of complications?

  8. What signs or symptoms should I watch for that may indicate a complication, such as PTH?

  9. How will PTH be treated if it occurs after the tonsillectomy?

  10. Are there any alternative treatments or procedures that may be considered instead of a tonsillectomy to address my condition?

Reference

Authors: Mitchell RM, Parikh SR. Journal: Otolaryngol Clin North Am. 2016 Jun;49(3):615-26. doi: 10.1016/j.otc.2016.03.008. PMID: 27267014