Rate of post-tonsillectomy haemorrhage in different tonsillectomy techniques: Retrospective study, Dubai hospital experience in 16-Month period

Abstract

Introduction: Tonsillectomy is one of the most common otolaryngology procedures performed. Haemorrhage has been divided into two broad categories; primary, occurring 24 h post-operation although commonly 5–10 days after the operation. Objectives: This study was conducted to determine the rate of post-tonsillectomy bleeding in our hospital, to review the rate of bleeding between different methods of tonsillectomy and to encourage surgeons with high bleeding rate to change to different techniques. Methods: It was a retrospective study conducted at the Department of Otolaryngology (ENT), Dubai Hospital, Dubai, United Arab of Emirates. It was conducted from 1st June 2014 to 30th September 2015. Study population were 554 patients who underwent tonsillectomy or adenotonsillectomy during this period. The patients were grouped into four groups according to the tonsillectomy technique. Results: Twenty-two patient presented with bleeding (3.97%). Out of these, one was primary post-tonsillectomy bleeding and 21 were secondary post-tonsillectomy bleeding. The highest rate of secondary post-tonsillectomy bleeding was in bipolar tonsillectomy group (8.98%), while the lowest rate was in radiofrequency group. The primary bleeding was encountered in one patient in cold dissection group while no primary bleeding was encountered in other groups. 40.9% of cases were managed surgically, while 59.1% were managed medically. Conclusion: Post-tonsillectomy bleeding is still a clinically significant complication despite advances in surgical techniques. Radiofrequency tonsillectomy has the lowest bleeding rate. Our hospital rate of bleeding stand in the international range and we are going to be better regarding secondary bleeding, but we are one of the best regarding primary.