Peritonsillar abscess – critical analysis of abscess tonsillectomy

Department of Otorhinolaryngology, Head and Neck Surgery, Philipps University of Marburg, Germany
Clinical Otolaryngology (Impact Factor: 2.39). 09/2003; 28(5):420 - 424. DOI: 10.1046/j.1365-2273.2003.00736.x

ABSTRACT The risk of secondary haemorrhage following abscess tonsillectomy is reported in the literature with differing rates. A retro- and prospective analysis of complication rates following abscess tonsillectomy was conducted in 142 patients (54 females, 88 males; mean age: 35 years). In 22% of patients, a secondary haemorrhage occurred. In half of these (11% of total), the haemorrhage had to be treated surgically. Secondary haemorrhage occurred most commonly on the 6th and 8th postoperative days. Reports in the literature are not in unison about the risk of secondary haemorrhage following abscess tonsillectomy and therefore allow no final judgement about an objective risk of this complication. This report strengthens the results of the ‘Comparative Audit Service’ analysis from 1997, which did show a high risk of secondary haemorrhage following tonsillectomy, as well as following abscess tonsillectomy.

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    ABSTRACT: The risk of operation-requiring postoperative bleeding after abscess tonsillectomy is no different from the risk after elective tonsillectomy. However, the risk is higher for older than for younger patients, both for the whole cohort and for tonsillectomy à chaud. The objective of the present study was to clarify whether the frequency of postoperative bleeding after tonsillectomy depends on gender, age or type of operation. Of 1365 patients, 47 (3.4%) needed reoperation for bleeding. Reoperation for bleeding was performed in 4.0% cases after tonsillectomy à chaud, and in 3.3% after tonsillectomy à froid. In a logistical regression analysis there proved to be no links between gender or type of operation. When patients were grouped according to age there was a significant 2.3 times higher risk of operation-requiring postoperative bleeding in patients above 35 than for patients under 35 years. Age dependence was greater for the à chaud group alone. Here, a significant age dependence (p = 0.047) was found, as patients above the age of 40 years were estimated to have a 2.5 times higher risk of operation-requiring postoperative bleeding (2/28) than patients under 40 (9/246).
    Acta oto-laryngologica 05/2012; 132(7):773-7. · 0.98 Impact Factor
  • HNO 04/2009; 57(3):223-9. · 0.42 Impact Factor
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    ABSTRACT: BACKGROUND: Studies have been conducted to determine 30-day and 365-day mortality rates after surgical procedures in different regions; however, there is a lack of data for mortality rates in New South Wales (NSW), Australia. The aim of this study was to determine 30-day and 365-day post-operative mortality rates after selected common operations performed in NSW. METHODS: Using the Centre for Health Record Linkage, we linked the NSW Admitted Patient Data Collection with the NSW Registry of Births, Deaths and Marriages and Australian Bureau of Statistics to retrospectively calculate 30-day and 365-day post-operative mortality rates for 21 selected surgical procedures between 2000 and 2009. One year (365 days) standardized mortality ratios, and proportion of public and private hospital admissions and mortality, were calculated for each procedure. RESULTS: Thirty-day mortality was lower than in previous studies for femur fracture fixation (3.7%), cervical spine fusion (0.8%), prostatectomy (0.2%), coronary valve replacement (4.2%), pulmonary resection (2.5%), bariatric surgery (0.07%) and pancreaticoduodenectomy (6.2%). Thirty-day mortality was higher than previously reported for abdominal aortic aneurysm (12.6%) and tonsillectomy (0.02%). One-year mortality rates ranged from 0.2% for tonsillectomy and bariatric surgery, to 24.6% for hip fracture fixation. CONCLUSIONS: Thirty-day mortality rates in NSW are similar, if not lower for most procedures when compared with rates reported in other studies. The reported mortality rates for each procedure allow clinicians and patients to be more informed of surgical risks.
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