Rare Complication Of Tonsillectomy Research Articles

132 Pseudoaneurysm of the Facial Artery After Tonsillectomy Managed with Endovascular Coiling: A Case Report

Abstract Introduction We present a case of pseudoaneurysm of the facial artery after tonsillectomy managed with successful endovascular coiling. Presentation of Case 41-year-old lady presented with a history of throat pain and 3 episodes of hematemesis on the 3rd, 4th, and 7th postoperative days after tonsillectomy and styloidectomy. She had undergone the operation 20 days back. Neurological examination was normal. Contrast-enhanced computed tomography scan of the neck showed – contrast-filled dilatation of a branch of the right facial artery in the right palatine tonsillar fossa within the operative bed – likely pseudoaneurysm which was managed endovascularly. The patient recovered fully after treatment. Discussion Tonsillectomy can have various complications among which one is the pseudoaneurysm of the facial artery which can be managed with coiling in the catheterization laboratory. Conclusions Pseudoaneurysm of the facial artery is a rare complication of tonsillectomy. Endovascular treatment of a pseudo aneurysm can be done.

The effect of different tonsillectomy techniques on taste sensation in the early and late postoperative periods

Objectives: Impairment in taste sensation is a rare complication of tonsillectomy. We aimed to reveal the effects of different tonsillectomy techniques on taste sensation by assessing the impairment in taste sensation in the early and late postoperative periods. Methods: In this prospective clinical study, fifty-seven (22 females, 35 males, mean age, 25 ± 9.8 years) patients who underwent tonsillectomy were included. All patients were operated on under general anesthesia, and a chemical stimulation taste test was performed one week prior to the surgery, at first week and first month postoperatively. Four basic taste sensations were assessed in the test (sweet, sour, salty, and bitter), and impairments in taste sensation in the early and late postoperative periods for each tonsillectomy technique were evaluated. Results: In the early postoperative period, there was a statistically significant increase bitter taste sensations in patients who underwent tonsillectomy (p = 0.020). In the late postoperative period, sour and bitter taste sensations were significantly increased in the patients (p = 0.001, p = 0.002; respectively). In contrast to the early postoperative period, total taste sensation was significantly increased in the late postoperative period (p = 0.034). Conclusions: The bitter sensation in the early postoperative period and the bitter and sour sensations in late postoperative period were found to be significantly increased in this present study.With regard to these results, a thorough preoperative explanation should be done.

Sepsis- An unusual post tonsillectomy complication

Tonsillectomy is a commonly performed procedure in children. Disseminated sepsis is a rare complication of tonsillectomy. Patients usually present with hypotension, reduced oxygen saturation, tachycardia with high total count and reduced urine output. Our patient also required NIV (non-invasive ventilation), ionotropes and antibiotics with serial blood examinations. Early diagnosis and prompt treatment will help in better outcome. The tonsils contain T lymphocytes and macrophages as they serve immune defense mechanisms. Tonsillitis is most commonly caused by viral infection, 40% of cases are caused by bacterial infection. Immunological functions like antigen transport and antibody production are altered in diseased tonsils. The presence of various micro organisms in the open tonsillar bed during and after tonsillectomy acts as foci of infection. The tissue reaction and presence of micro-organisms is also due to different surgical techniques involved. Keywords: Tonsillectomy, Sepsis, Hypotension, Inflammation.

Peripheral facial nerve palsy-A rare complication of tonsillectomy

Tonsillectomy is a common surgical procedure often done by otolaryngologist in his/her routine surgical practice. Transient facial nerve palsy is an extremely rare complication of tonsillectomy. The cause of the facial nerve palsy may be due to infiltration of local anesthetic agent into parapharyngeal space and affecting facial nerve. Infiltration of local anesthetic solution into the peritonsillar tissue is commonly used for reduction of pain, although the benefit and risk of complication of this technique have not yet been well established. Here, we presented a rare incidence of facial nerve palsy seen in a 14-year-old boy who underwent tonsillectomy under general anesthesia with local infiltration of bupivacaine at peritonsillar space. The facial nerve palsy was completely recovered by conservative treatment.

Disgeusia: a propósito de um caso clínico

Introduction: The distortion of the sense of taste (dysgeusia), transient or permanent, may have significant impact on the lives of patients. It may be associated with weight loss, anorexia, malnutrition, depressive symptoms, and a significant reduction in quality of life. Dysgeusia can have several causes. One surgical cause is tonsillectomy. Case description: A 38 year-old female patient, with dysgeusia is presented. She had a history of bilateral chronic tonsillitis and a cold blade tonsillectomy was performed with electrocautery of tonsillar hemorrhages without complications. After surgery she complained of dysgeusia characterized by lack of taste discrimination, stating that all foods seemed bitter. Six months after surgery, at a follow-up consultation, her gustatory function was evaluated with taste strips. This revealed changes in taste discrimination. She experienced a bitter taste, even when stimulated with sour, sweet or salty stimuli. The patient began daily gustatory rehabilitation, working on mental associations with sensory stimuli. She repeated the gustometry one year after surgery. The patient improved, although selective dysgeusia persisted with a bitter sensation in the presence of salt at low concentration. Comment: Dysgeusia is a rare complication of tonsillectomy, but can have great impact on the lives of patients. The surgical procedure can damage sensory nerves responsible for taste, directly or indirectly. There are few therapeutic options. Cases are under reported in the literature, and tend to be benign. Dysgeusia can have various causes, such as antihypertensive drugs, poor oral hygiene, surgery, infection, smoking, diabetes, autoimmune diseases, anti-microbial agents, and anti-inflammatory drugs. In primary health care, taste complaints often have no obvious explanation at the initial presentation. In Portugal there is no data on their incidence. It is important to sensitize clinicians to this disease. Patients’ complaints about changes in taste should be addressed because of the impact that it has on the quality of life and possible treatable causes. Patients with dysgeusia require assessment, advice and treatment.

Cervicofacial subcutaneous emphysema, a rare complication of tonsillectomy

Tonsillectomy is one of the most common surgical procedures performed worldwide, and because of that, it is regarded by surgeons and patients as a relatively safe procedure. One of the very rare complications post tonsillectomy is subcutaneous emphysema, as in our case here. Although most reported cases are resolved spontaneously, it may lead to potentially fatal complications, like tension pneumothorax. The mechanism for the development of subcutaneous emphysema is not well understood. We are reporting a rare case of healthy man, developed subcutaneous emphysema 4days after tonsillectomy evident by clinical and radiological examination.

Candida infection after tonsillectomy in a 12-year-old girl

Abstract Tonsillectomy has been associated with complications such as bleeding, pain, dehydration, edema, airway obstruction, atlantoaxial subluxation and infection. However, fungal infection is a very rare complication of tonsillectomy. We describe the case of a 12-year-old girl who developed oral Candida infection as a complication of tonsillectomy. She had pain and difficulty in swallowing on the third postoperative day, and a local examination revealed an easily grazing, white plate on the tonsillar fossa. A culture of the lesion tissue identified Candida albicans . Local nystatin therapy was administered, and the lesion healed completely by postoperative day 12. We conclude that fungal infection, though rare, can occur as a complication of tonsillectomy.

Subcutaneous Emphysema and Pneumomediastinum after Tonsillectomy

Cervicofacial subcutaneous emphysema is a rare complication of tonsillectomy that often resolves spontaneously but may progress to obstruct upper airways or spread to the thorax causing pneumomediastinum or pneumothorax. The mechanisms by which subcutaneous emphysema and pneumomediastinum may develop after tonsillectomy are poorly understood. A case of a 21-year-old female undergoing routine adenotonsillectomy, who developed cervicofacial emphysema and pneumomediastinum, is presented. Possible pathogenetic mechanisms and treatment options are discussed.

Grisel's syndrome: a rare complication of tonsillectomy

To discuss the pathophysiology of atlanto-axial subluxation as a rare complication of tonsillectomy, and to discuss the important radiological findings for diagnosis and treatment planning. We report a case of post-tonsillectomy atlanto-axial subluxation, also known as Grisel's syndrome, in a child. On the third day after surgery, the boy presented with torticollis with no neurological deficit. Rotatory atlanto-axial subluxation was clearly shown in computed tomography scans of the neck. Cervical traction for one week successfully reduced the subluxation, with no long-term sequelae. Pre-existing cervical ligamentous laxity and post-operative infection are believed to be the main causes of Grisel's syndrome. Although it is rare, patients are advised to seek treatment early if any neck pain or fever persists. Early diagnosis is important for better treatment outcome. Initial conservative measures are advised before more invasive cervical traction is adopted.

Subcutaneous Emphysema A rare complication of tonsillectomy

Cervical subcutaneous emphysema results from the entry of air into the muscle planes and subcutaneousplanes. It can rarely be seen after tonsillectomy. We report this rare complication in a 20 year old femaleoperated for chronic tonsillitis with history of peritonsillar abscess in past. The case is reported for itsrarity. The pathogenesis and management of this complication is presented with the review of literature.Key Words: Tonsillectomy, Subcutaneous emphysema, Cervical.