Our Summary

This research paper examines the reasons children might have to return to the hospital after having their tonsils removed, a procedure known as a tonsillectomy. It’s a common surgery, but one that often requires kids to go back to the hospital due to complications. The researchers looked at data from nearly 50,000 surgeries performed in Victoria, Australia between 2010 and 2015. They found that about 1 in 10 kids had to visit the emergency room after their surgery, and around 1 in 20 were re-admitted to the hospital. Most of these return visits were due to bleeding. The researchers also found that these return visits were more common in older children, those who had their surgery at public or city hospitals, and those who had complications during their surgery. The study suggests that better education for caregivers on how to care for kids after surgery, and not discharging patients too early, could help reduce these return visits.

FAQs

  1. What complications often lead children to return to the hospital after a tonsillectomy?
  2. Were there any specific factors that increased the likelihood of children needing to return to the hospital post-tonsillectomy?
  3. What strategies does the study suggest could help reduce the number of return visits to the hospital after a tonsillectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient about tonsillectomy is to closely monitor for any signs of bleeding after the surgery. If there is any excessive bleeding, it is important to seek medical attention immediately. It is also important to follow all post-operative care instructions provided by the doctor to ensure a smooth recovery process. Additionally, staying hydrated and getting plenty of rest can help aid in the healing process.

Suitable For

Patients who are typically recommended tonsillectomy include:

  1. Children with recurrent tonsillitis: Tonsillectomy is often recommended for children who have frequent episodes of tonsillitis (usually seven or more episodes in one year, five or more episodes for two years, or three or more episodes for three years).

  2. Children with obstructive sleep apnea: Tonsillectomy may be recommended for children with obstructive sleep apnea, a condition in which the airway is partially or completely blocked during sleep, leading to pauses in breathing.

  3. Children with enlarged tonsils: Tonsillectomy may be recommended for children with significantly enlarged tonsils that are causing difficulty breathing, swallowing, or speaking.

  4. Children with recurrent peritonsillar abscess: Tonsillectomy may be recommended for children who have had multiple episodes of peritonsillar abscess, a painful collection of pus near the tonsils.

  5. Children with complications from tonsillitis: Tonsillectomy may be recommended for children who have complications from tonsillitis, such as difficulty eating or breathing, or recurrent ear infections.

It is important for patients and caregivers to discuss the potential risks and benefits of tonsillectomy with their healthcare provider before deciding to proceed with the surgery.

Timeline

Before tonsillectomy:

  • Patient meets with an ear, nose, and throat (ENT) specialist to discuss the need for the surgery and any potential risks or complications.
  • Patient may undergo pre-operative testing, such as blood work or a physical examination.
  • Patient is instructed to stop taking certain medications, such as blood thinners, in the days leading up to the surgery.
  • Patient is instructed on what to expect during the surgery and how to prepare for the recovery period.

After tonsillectomy:

  • Patient is monitored in the recovery room for a period of time before being discharged home.
  • Patient is given instructions on how to care for their throat and manage pain at home.
  • Patient may experience sore throat, difficulty swallowing, and ear pain in the days following the surgery.
  • Patient is advised to consume a soft diet and stay hydrated to promote healing.
  • Patient may have a follow-up appointment with their ENT specialist to ensure proper healing and address any concerns.
  • Patient may experience complications, such as bleeding, infection, or dehydration, that could require a return visit to the hospital.

What to Ask Your Doctor

  1. What are the potential risks and complications of a tonsillectomy?
  2. How long is the recovery period typically for a tonsillectomy?
  3. What can I do to help manage my child’s pain and discomfort after the surgery?
  4. What signs of complications should I watch for after the surgery?
  5. How soon after the surgery should I contact you if I have concerns or notice any unusual symptoms?
  6. Are there any specific dietary restrictions my child should follow after the surgery?
  7. Are there any activities my child should avoid during the recovery period?
  8. Will my child need any follow-up appointments after the surgery?
  9. What should I do if my child experiences bleeding after the surgery?
  10. How can I best support my child emotionally during the recovery process?

Reference

Authors: Tran AHL, Chin KL, Horne RSC, Liew D, Rimmer J, Nixon GM. Journal: J Otolaryngol Head Neck Surg. 2022 Jan 12;51(1):1. doi: 10.1186/s40463-021-00552-8. PMID: 35022073