Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T13:47:44.377Z Has data issue: false hasContentIssue false
  • English
  • Français

Morbidity and mortality of post-tonsillectomy bleeding: analysis of cases

Published online by Cambridge University Press:  12 March 2007

D Cohen  and
M Dor
D Cohen*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Shaare Zedek Medical Centre, Jerusalem, Israel
M Dor
Affiliation:
General Medical Division, Medical Administration, Israel Ministry of Health, Jerusalem, Israel
*
Address for correspondence: Dr David Cohen, Department of Otolaryngology/Head and Neck Surgery, Shaare Zedek Medical Centre, Jerusalem, Israel. Fax: +972 2 651 0808 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To analyse the circumstances of mortality in post-tonsillectomy bleeding cases, in order to better manage serious problems during resuscitation.

Design:

Reports of inquiry committees on post-tonsillectomy mortalities.

Setting:

State of Israel Ministry of Health committees.

Participants:

Senior otolaryngologists and related professionals, and the involved medical staff who participated in the inquiry committees.

Main outcomes measures:

Identification of actions causing undesirable effects on resuscitation outcomes.

Results:

In recent years, the post-tonsillectomy mortality rate in Israel has been one in 12 000. The two main causes of death have been severe haemorrhagic shock and airway obstruction.

Conclusions:

Active bleeding should be treated, rather than waiting for spontaneous resolution. An efficient airway should be established early during resuscitation, either by intubation (within two minutes) or by cricothyroidotomy. The two main factors endangering the patient's life during resuscitation are severe blood loss, interfering with effective cardiac output, and airway obstruction. Blood loss should be quickly substituted.

Keywords

TonsillectomyComplicationsMortalityIsrael
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 1 , January 2008 , pp. 88 - 92
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Peeters, A, Van Rompay, D, Schmelzer, B, Vidts, G, Katz, S. Tonsillectomy and adenotomy as a one day procedure? Acta Otorhinolaryngol Belg 1999;53:91–7Google ScholarPubMed
2Lalakea, ML, Marquez-Biggs, I, Messner, AH. Safety of short-stay tonsillectomy. Arch Otolaryngol Head Neck Surg 1999;125:749–52CrossRefGoogle ScholarPubMed
3Chiang, TM, Sukis, AE, Ross, DE. Tonsillectomy performed on an outpatient basis. Arch Otolaryngol 1968;88:105–10CrossRefGoogle Scholar
4Handler, SD, Miller, L, Richmond, KH, Baranak, CC. Post-tonsillectomy haemorrhage: incidence and management. Laryngoscope 1986;96:1243–7CrossRefGoogle Scholar
5Windfuhr, JP, Sesterhenn, K. Haemorrhage after tonsillectomy. Analysis of 229 cases [in German]. HNO 2001;49:706–12CrossRefGoogle ScholarPubMed
6Ross, AT, Kazahaya, K, Tom, LWC. Revisiting outpatient tonsillectomy in young children. Otolaryngol Head Neck Surg 2003;128:326–31CrossRefGoogle ScholarPubMed
7Carmody, D, Vamadevan, T, Cooper, SM. Post tonsillectomy haemorrhage. J Laryngol Otol 1982;96:635–8CrossRefGoogle ScholarPubMed
8Windfuhr, JP. Lethal post-tonsillectomy haemorrhage. Auris Nasus Larynx 2003;30:391–6CrossRefGoogle Scholar
9Chowdhury, K, Tewfik, TL, Schloss, MD. Post-tonsillectomy and adenoidectomy haemorrhage. J Otolaryngol 1988;17:46–9Google Scholar
10Irani, DB, Berkowitz, RG. Management of secondary haemorrhage following pediatric adenotonsillectomy. Int J Pediatr Otolaryngol 1997;40:115–24CrossRefGoogle ScholarPubMed
11Windfuhr, JP. Excessive post-tonsillectomy haemorrhage requiring ligature of the external carotid artery. Auris Nasus Larynx 2002;29:317–18CrossRefGoogle ScholarPubMed
12Windfuhr, JP, Chen, YS. Incidence of post-tonsillectomy haemorrhage in children and adults: study of 4,848 patients. Ear Nose Throat J 2002;81:626–8CrossRefGoogle Scholar
13Khan, EAS, Young, D, Adamson, R. Assessment of secondary haemorrhage rates following adult tonsillectomy – a telephone survey and literature review. Clin Otolaryngol 2003;28:489–91Google Scholar
14Capper, JWR, Randall, C. Post-operative haemorrhage in tonsillectomy and adenoidectomy in children. J Laryngol Otol 1984;98:363–5CrossRefGoogle ScholarPubMed
15Peeters, A, Claes, J, Saldien, V. Lethal complications after tonsillectomy. Acta Otorhinolaryngol Belg 2001;55:207–13Google ScholarPubMed
16Vaiman, M, Eviatar, E, Shlamkovitz, N, Segal, S. Effect of modern fibrin glue on bleeding after tonsillectomy and adenoidectomy. Ann Otol Rhinol Laryngol 2003;112; 410–14CrossRefGoogle ScholarPubMed
17Linden, BE, Gross, CW, Long, TE, Lazar, RH. Morbidity in pediatric tonsillectomy. Laryngoscope 1990;100:120–4CrossRefGoogle ScholarPubMed
18Bennet, AMD, Clark, AB, Bath, AP, Montgomery, PQ. Meta-analysis of the timing of haemorrhage after tonsillectomy: an important factor in determining the safety of performing tonsillectomy as a day case procedure. Clin Otolaryngol 2005;30:418–23CrossRefGoogle Scholar
19Windfuhr, JP, Chen, YS. Post-tonsillectomy and -adenoidectomy haemorrhage in nonselected patients. Ann Otol Rhinol Laryngol 2003;112:63–70CrossRefGoogle ScholarPubMed
20Postma, DS, Folsom, F. The case for an outpatient “approach” for all pediatric tonsillectomies and/or adenoidectomies: a 4-year review of 1419 cases at a community hospital. Otolaryngol Head Neck Surg 2002;127:101–8CrossRefGoogle ScholarPubMed
21Kay, DJ, Mehta, V, Goldsmith, AJ. Perioperative adenotonsillectomy management in children: current practices. Laryngoscope 2003;113:592–7CrossRefGoogle ScholarPubMed