Our Summary

This research paper looks into the frequency of bleeding after a child has their tonsils removed (posttonsillectomy hemorrhage or PTH), as well as the number of children who needed to go back to the hospital or have another operation because of this. In order to do this, the researchers looked at various studies and collected key data.

The results showed that less than 4% of children experienced bleeding after having their tonsils removed, regardless of the surgical method used. The rate of bleeding was less than 5% overall, and was slightly lower for partial tonsillectomy (removal of part of the tonsils) compared to total tonsillectomy (complete removal of the tonsils).

Fewer episodes of post-operation bleeding occurred when the tonsillectomy was done due to sleep-disordered breathing issues, compared to when it was done due to throat infections.

The rate of children who had to go back to the hospital or have another operation due to post-operation bleeding ranged from 0.2% to 5.7% for total tonsillectomy, and from 0.1% to 3.7% for partial tonsillectomy.

Unfortunately, there were at least 4 deaths reported among the almost 1.8 million children included in the studies.

The conclusion is that while tonsillectomy is generally safe, there is still a small risk of post-operation bleeding. However, the researchers couldn’t determine if one particular surgical technique was better than another.

FAQs

  1. What is the rate of posttonsillectomy hemorrhage (PTH) in children following a tonsillectomy?
  2. Does the risk of post-operation bleeding differ between total and partial tonsillectomy?
  3. What is the rate of rehospitalization or repeat surgery due to post-operation bleeding after a tonsillectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tonsillectomy is to follow post-operative care instructions closely to reduce the risk of complications such as bleeding. This may include avoiding strenuous activities, staying hydrated, eating soft foods, and taking prescribed pain medication as directed. It’s also important to contact your healthcare provider if you experience excessive bleeding or other concerning symptoms after the surgery.

Suitable For

Overall, patients who are typically recommended for tonsillectomy include those who have recurrent tonsillitis or throat infections, obstructive sleep apnea, or enlarged tonsils that are causing difficulty breathing or swallowing. Additionally, patients who have had a history of peritonsillar abscess or difficulty with speech or swallowing due to enlarged tonsils may also be recommended for tonsillectomy. It is important for patients and their caregivers to discuss the risks and benefits of tonsillectomy with their healthcare provider to determine if it is the best course of treatment for their specific condition.

Timeline

Before tonsillectomy:

  • Patient may experience recurrent throat infections, difficulty breathing, or sleep-disordered breathing
  • Consultation with an ear, nose, and throat (ENT) specialist to discuss the need for tonsillectomy
  • Pre-operative evaluation to assess the patient’s overall health and determine if they are a candidate for surgery
  • Patient and family education on the procedure, risks, and recovery process

After tonsillectomy:

  • Patient undergoes the surgical procedure to remove the tonsils
  • Recovery period at home with pain management and follow-up appointments with the ENT specialist
  • Monitoring for signs of bleeding, infection, or other complications
  • Gradual return to normal activities and diet as instructed by the healthcare provider
  • Improvement in symptoms such as reduced throat infections, improved breathing, and overall better quality of life

Overall, the timeline for a patient before and after tonsillectomy involves a thorough evaluation, the surgical procedure itself, and a recovery period with close monitoring for any potential complications. The goal is to provide relief from symptoms and improve the patient’s overall health and well-being.

What to Ask Your Doctor

  1. What are the potential risks and complications of a tonsillectomy, including the risk of post-operation bleeding?
  2. How common is post-operation bleeding after a tonsillectomy?
  3. What symptoms should I watch out for that may indicate post-operation bleeding?
  4. What should I do if I experience bleeding after my tonsillectomy?
  5. How soon after the surgery should I contact you if I experience bleeding?
  6. Are there any factors that may increase my risk of post-operation bleeding?
  7. What steps can I take to reduce my risk of post-operation bleeding?
  8. How often will I need to follow up with you after my tonsillectomy to monitor for any complications?

Reference

Authors: Francis DO, Fonnesbeck C, Sathe N, McPheeters M, Krishnaswami S, Chinnadurai S. Journal: Otolaryngol Head Neck Surg. 2017 Mar;156(3):442-455. doi: 10.1177/0194599816683915. Epub 2017 Jan 17. PMID: 28094660