Tonsillectomy | Purpose, Contraindications, Procedure, Recovery and Complications

Complications of tonsillectomy

There are multiple complications following the tonsillectomy

1. Bleeding or hemorrhage

It is a common complications after tonsillectomy surgery. Around 2-3% of patients have bleeding. A study conducted by Rakover et al. to evaluate the risk of postoperative bleeding in pediatrics after tonsillectomy. They founded that; bleeding occurred in children who were classified as high risk for bleeding.

Another review by Randall DA et al. to study the complication of tonsillectomy and adenoidectomy. They founded that; the prevalence of hemorrhage was ranging from 0.1% to 8.1%, and the incidence increases in winter than in summer. They also founded the bleeding incidence increases with age.

On the other hand, a systematic review by De Luca et al. to identify the most frequent risks after adenotonsillectomy. The authors founded that; bleeding is not the most frequent complication with 2.6% prevalence between children.

A retrospective study by Warad et al. to assess the hemorrhagic risk of post adenotonsillectomy in pediatrics and young adults with a bleeding disorder. The study showed that; despite extensive care of hemostasis intraoperatively, and a good executed surgical technique, the risk of bleeding was high especially in patients with bleeding disorders.

Post-tonsillectomy bleeding can be classified into several types

    • Intraoperative bleeding
    • Primary (early) bleedingwhich occurs in the first twenty-four hours after the procedure
    • Secondary (late) bleedingwhich occurs after seven to ten days after the procedure

For patients undergoing tonsillectomy, blood transfusion is required in 0.04% of patients, while postoperative mortality due to bleeding is about 0.002%.

Bleeding after tonsillectomy usually responds to cautery or to applied pressure using a pack with local vasoconstrictors. Treatment of bleeding with electrocautery is faster, and more effective than ligation.