Abscess tonsillectomy: uni- or bilateral?

Objective Postoperative bleeding after tonsillectomy (TE) is this operation’s most feared complication and can lead in rare cases to patient’s death. The objective of this study was to analyze if a bilateral tonsillectomy (TE) for an unilateral peritonsillar abscess (PTA) causes more bleeding than the TE of the abscess side alone.

Methods Retrospective study of n= 2762 patients who had tonsillar surgery in the Otolaryngology department of the University of Erlangen-Nürnberg between January 2004 and February 2019. A bilateral tonsillectomy (TE) for acute recurrent tonsillitis was performed in n = 2123 cases and an uni- or bilateral abscess tonsillectomy was performed in n = 639 cases (ABTE).

Results 9/639 (1,4 %) patients presented with postoperative bleeding after ABTE and 63/2123 (2,9 %) after tonsillectomy for acute recurrent tonsillitis. 8/9 (88,9 %) patients showed bleeding after ABTE with additional contralateral tonsillectomy. In 4/8 cases (50 %) the bleeding occured at the contralateral side and in 4/8 cases (50 %) there was bilateral bleeding. In 1,4 %, patients with unilateral ABTE needed an abscess tonsillectomy of the contralateral side in the future.

Conclusion The rates of postoperative bleeding after bilateral TE (2,9 %) as well as ABTE (1,4 %) were low. P Postoperative bleeding after bilateral ABTE (1,3 %) was higher compared to unilateral ABTE (0,16 %). Additionally, postoperative bleeding after bilateral ABTE is as frequent as the indication of the contralateral TE after unilateral ABTE. Therefore, indication for surgery should be made thoughtfully and individually for every patient.

Poster-PDF A-1959.PDF

Publication History

Article published online:
10 June 2020