Intensity of hemorrhage following tonsillectomy

Abstract

Background/aim: Although post-tonsillectomy hemorrhage is one of the most frequent and potentially life-threatening complications, there is no generally accepted classification of post-operative bleeding intensity. The aim of this study was to evaluate the intensity of post-tonsillectomy hemorrhage according to the five-grade classification.

Methods: A total of 408 consecutive patients, aged 2 to 54 years, undergoing elective tonsillectomy, with (n = 261) or without (n = 147) adenoidectomy, were included in this prospective study. Tonsillectomy was performed under general anesthesia using standard technique of cold dissection with a snare. Any bleeding event was recorded. The severity of post-operative hemorrhage was classified in five grades.

Results: In 11 (2.70%) of the patients grade 1 hemorrhage following tonsillectomy occurred, 4 (0.98%) had grade 2 and 2 (0.49%) of the patients had grade 3 post-operative bleeding. Grades 4 and 5 were not recorded, and no patient received a blood transfusion.

Conclusion: Post-tonsillectomy hemorrhage can be expected in a small number of patients undergoing tonsillectomy. Hemorrhage is mostly primary and rarely requires treatment under endotracheal anesthesia and blood transfusion.