Post-operative haemorrhage after acute bilateral tonsillectomy in patients with peritonsillar abscess: prevalence, treatment, risk factors, and side of bleeding. (2nd January 2020)

• Record Type: Journal Article
• Authors: Nami Saber, Camelia; Klug, Tejs Ehlers
• Is Part Of: Acta oto-laryngologica. Volume 140:Number 1(2020)
• Page Start: 66
• Page End: 71
• Publication Date: 2020-01-02
• Subjects: Post-tonsillectomy haemorrhage -- acute tonsillectomy -- peritonsillar abscess -- quinsy -- microbiology -- risk factors; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2019.1682189
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Background: Bilateral quinsy tonsillectomy (QT) in patients with peritonsillar abscess (PTA) is associated with the risk of post-tonsillectomy haemorrhage (PTH) and current literature finds a significantly higher risk of PTH contralaterally to the quinsy. Aims: To determine the prevalence of PTH in a large cohort of patients undergoing QT, explore risk factors for PTH, describe our methods of treatment, and evaluate if contralateral haemorrhage is more common than ipsilateral haemorrhage. Materials & methods: All patients undergoing QT at Aarhus University Hospital in the period 2001–2017 were included in the study. Results: One hundred sixteen of 1671 (6.9%) QT patients were admitted with PTH. PTH patients were significantly more frequently males (66%) and infected with Streptococcus group A (GAS) (31%) compared to QT patients without PTH (53% and 18%, respectively) ( p = .005 and p = .002, respectively). Haemostasis was obtained in general anaesthesia ( n = 61) or local anaesthesia ( n = 28) and stopped spontaneously in 25 patients. The side of PTH was not associated with the side of PTA (ipsilateral ( n = 41), contralateral ( n = 43), and bilateral PTH ( n = 23), p = .93). Conclusions and significance: Our findings question if unilateral QT is preferable to bilateral QT when the PTA does not respond to conservative treatment, especially in males with GAS-positive PTA.