Assessment of risk factors for secondary post-tonsillectomy hemorrhage in children

Abstract

Background: Tonsillectomy, with or without adenoidectomy, is well recognized as one of the most often done surgical procedures in the field of pediatrics. It is commonly recommended for many reasons, such as repeated episodes of adenotonsillitis, obstructive sleep apnea, and peritonsillar abscesses. The aim of this study was to evaluate and assess the significance of the possible risk factors for secondary post tonsillectomy haemorrhage in children. Methods: This prospective study was carried out on 70 patients aged from 3 to18 years old, both sexes, presented with secondary post tonsillectomy haemorrhage. Complete otorhinolaryngological clinical examination to detect tonsillar bed infection (purulent exudate from tonsillar bed, fever, sore throat with bad odor of the mouth) and severity of hemorrhage which is either minimal hemorrhage stopped spontaneously are assessed to all patients. Results: Young age (3-5 years), female sex, number of attacks/ year and postoperative hemoglobin (Hb) level, cold season, Hot techniques of tonsillectomy (unipolar tonsillectomy), and analgesic (ibuprofen) were significant predictors of secondary post tonsillectomy hemorrhage (PTH) requiring management either conservative or second surgical intervention whereas other parameters were insignificant predictors. Conclusions: There are numerous risk factors associated with secondary post-tonsillectomy bleeding in children. Analgesic (ibuprofen) were significant predictors of secondary PTH requiring management either conservative or second surgical intervention whereas other parameters were insignificant predictors.