Abstract
The objective of this study is to evaluate the effect of tonsillar fossa closure after tonsillectomy on the amount of intra-operative blood loss, post-operative pain and bleeding. Sixty patients enrolled in this single blind case control study held at Basrah Teaching Hospital in the period from July 2017 to November 2018. Patients age was between 7 to 50 years, of them 28 (46.7%) females and 32 (53.3%) males. One of tonsillar fossae was selected for closure and the other was left open as a control side, the duration of dissection, the amount of bleeding for each side, the level of post-operative pain on (0, 3, 7, 10-14) days was estimated utilizing Visual Analogue Score (VAS) together with any evidence of post-operative bleeding. There was statistically significant reduction in the level of post-operative pain in the sutured side compared to the control for all the follow-up periods. No significant differences in the amount of intra-operative blood loss between both sides were found. None of the patients experienced post-operative primary or secondary hemorrhage. In conclusion, Closure of tonsillar fossa has beneficial effect in reducing the level of post-operative pain after tonsillectomy with no effect on post-operative bleeding. No difference was noted regarding the amount of intra-operative bleeding.
Highlights
The objective of this study is to evaluate the effect of tonsillar fossa closure after tonsillectomy on the amount of intra-operative blood loss, post-operative pain and bleeding
Patients admitted for adenotonsillectomy were not included in this study to overcome the cumulative effect of pain caused by adenoidectomy and to avoid the extra amount of blood loss coming from the adenoid during dissection
Pain, haemorrhage, edema, and infection are all a well known post tonsillectomy complications that usually occur in the early post-operative period[13,14,15]
Summary
The objective of this study is to evaluate the effect of tonsillar fossa closure after tonsillectomy on the amount of intra-operative blood loss, post-operative pain and bleeding. One of tonsillar fossae was selected for closure and the other was left open as a control side, the duration of dissection, the amount of bleeding for each side, the level of post-operative pain on (0, 3, 7, 10-14) days was estimated utilizing Visual Analogue Score (VAS) together with any evidence of post-operative bleeding. Closure of tonsillar fossa has beneficial effect in reducing the level of post-operative pain after tonsillectomy with no effect on post-operative bleeding. Because the healing of the fossae will be by secondary intention, so there will be a time for the bed to exposes to external environment that in turn will cause edema and spasm of the underlying muscle with considerable pain post-operatively. The present study tries to learn the effect of protecting the fossae from irritation by the external environment, decreasing the nerve irritation, decreasing the edema and spasm of muscle fibers by closing the tonsillar fossa and isolating it from the exterior through suturing the pillars together
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