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Tonsillectomy complications

Jeffrey Steinberg, Vincent Cheung, Gunjan Goel, J Scott Pannell, Javan Nation, Alexander Khalessi
Although there have been reports of carotid artery pseudoaneurysm formation after adenoidectomy and/or tonsillectomy secondary to iatrogenic injury, there are no case reports of successful endovascular reconstruction of the injured artery in the pediatric population. In most pediatric cases, the internal carotid artery (ICA) is sacrificed. The authors report on a 6-year-old girl who presented with odynophagia, left-sided Horner's syndrome, hematemesis, and severe anemia 6 months after a tonsillectomy. On examination she was found to have a pulsatile mass along the left posterior lateral oropharynx, and imaging demonstrated a dissection of the extracranial left ICA and an associated pseudoaneurysm...
September 30, 2016: Journal of Neurosurgery. Pediatrics
Magdy Abdalla Sayed El-Ahl, Mohammad Waheed El-Anwar
The aim of this study was to introduce and assess a new minimally invasive expansion pharyngoplasty for obstructive sleep apnea (OSA) using bilateral new advancement sutures without tonsillectomy. Among 24 patients who had OSA with Friedman stage II or III and type I Fujita, bilateral sutures were performed to advance and stabilize palatopharyngeus and palatoglossus muscles anterolaterally. Mean apnea hypopnea index decreased significantly from 28.6 ± 4.2 preoperatively to 8.9 ± 4.9 postoperatively. The lowest oxygen saturation increased significantly from 79...
September 20, 2016: Otolaryngology—Head and Neck Surgery
Mohammad Hossein Dadgarnia, Mohammad Ali Aghaei, Saeid Atighechi, Nasim Behniafard, Mohammad Reza Vahidi, Mojtaba Meybodian, Vahid Zand, Maryam Vajihinejad, Abdollah Ansari
OBJECTIVE: Although tonsillectomy is one of the most common surgeries performed in pediatric, it has potential major complications such as pain and bleeding. This study aimed to compare the bleeding and pain after tonsillectomy in bipolar electrocautery tonsillectomy versus cold dissection. METHODS: This double blind clinical trial was conducted on 70 pediatric patients who were candidate of tonsillectomy. Patients were divided into two groups of including bipolar cautery (BC) and cold dissection (CD)...
October 2016: International Journal of Pediatric Otorhinolaryngology
Zorik Spektor, David J Kay, David L Mandell
PURPOSE: To compare post-operative pain severity, analgesic intake, and complications in children undergoing tonsillectomy and adenoidectomy with bipolar radiofrequency ablation (Coblation) vs. pulsed-electron avalanche knife (PEAK) technology. MATERIALS AND METHODS: This was a prospective, non-randomized, non-blinded comparative cohort study in a private practice setting with three fellowship-trained pediatric otolaryngologists. Patients aged 3 to 12years undergoing tonsillectomy and adenoidectomy were assigned to surgery with either bipolar radiofrequency ablation or pulsed electron avalanche knife instrumentation...
August 5, 2016: American Journal of Otolaryngology
Panagiotis Saravakos, Joerg Hartwein
Post-tonsillectomy hemorrhage is one of the most common complications of tonsillectomy. The rate varies with different methods. We retrospectively analyzed patients who underwent tonsillectomy in a period of two years. Two surgical methods, cold dissection and microscopically assisted bipolar tonsillectomy, were compared. 1007 patients were included in the study. Postoperative hemorrhage occurred in 116 patients (11.5 %). By the cold dissection method, postoperative bleeding was noted in 86 patients (10.9 %), while by the microscopic bipolar method in 30 patients (13...
August 20, 2016: European Archives of Oto-rhino-laryngology
David Kasle, Jordan Virbalas, John P Bent, Jeffrey Cheng
OBJECTIVE: To identify predictors of post-operative respiratory complications in children undergoing tonsillectomy. METHODS: Consecutive case series with chart review of children who underwent polysomnography (PSG) and subsequent tonsillectomy with or without adenoidectomy for obstructive sleep apnea (OSA). Patients with craniofacial anomalies or significant cardiopulmonary comorbidities were excluded. Rates of post-surgical respiratory complication were reviewed and compared to patient specific factors and PSG findings to identify possible risk factors...
September 2016: International Journal of Pediatric Otorhinolaryngology
Jennifer C Lane, James Dworkin-Valenti, Lisa Chiodo, Michael Haupert
OBJECTIVE & HYPOTHESIS: Stated in the Null form: There will be no difference in primary or secondary hemorrhage rate in children undergoing tonsillectomy or adenotonsillectomy across three surgical techniques: PEAK Plasmablade, electric monopolar cautery, coblation. STUDY DESIGN: Retrospective chart analysis. SETTING: Academic Medical Center: Children's Hospital. SUBJECTS & METHODS: Electronic chart data were collected from patient's age 2-18 years who underwent tonsillectomy, with or without adenoidectomy, at a tertiary pediatric hospital between June 2011 to May 2013 by electric monopolar cautery, coblation, or PEAK PlasmaBlade...
September 2016: International Journal of Pediatric Otorhinolaryngology
Yuri Choi, Su-Gwan Kim, Seong-Yong Moon, Ji-Su Oh, Jae-Seek You, Kyung-In Jeong, Sung-Seok Lee
Osteoradionecrosis is one of the most serious complications of patients receiving radiation therapy. It is characterized by hypovascularity, hypocellularity, and hypoxia-inducing necrosis of bone and soft tissue following delayed healing. In this case, a 72-year-old man was referred to the Department of Oral and Maxillofacial Surgery complaining of trismus following extraction three months before first visit. He had a history of right tonsillectomy, radical neck dissection and radiotherapy performed due to right tonsillar cancer seven years prior...
March 2014: Maxillofacial Plastic and Reconstructive Surgery
Filippo Montevecchi, Giovanni Cammaroto, Giuseppe Meccariello, Giovanni D'Agostino, Ying-Shuo Hsu, Bruno Galletti, Claudio Vicini
BACKGROUND: Lingual tonsillitis is an underestimated but serious health problem. This paper describes the feasibility and efficacy of the trans-oral robotic surgical approach in cases of lingual tonsillitis. MATERIALS AND METHODS: From February 2012 to April 2014, 10 patients affected by lingual tonsillitis resistant to medical treatments underwent transoral robotic lingual tonsillectomy at the authors' Institution. RESULTS: The surgical robotic procedure was completed in all cases and there was no need to change the operative approach once started...
August 2, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Hui Tong Wong, Tan Sien Hui, Aun Wee Chong
INTRODUCTION: Tonsillectomy is one of the most common procedures performed by Ear, Nose, and Throat surgeon. Usually, the procedure is carried out as an inpatient surgery. With the increasing need to reduce healthcare costs, spare precious hospital beds, and shorten elective surgery lists, there is currently a trend towards performing tonsillectomy on a daycare basis. MATERIALS AND METHODS: A prospective review of all tonsillectomies performed at the University Malaya Medical Center was undertaken for the year 2013...
May 2016: Iranian Journal of Otorhinolaryngology
Julie Longard, Alison Twycross, Anna M Williams, Paul Hong, Jill Chorney
AIMS AND OBJECTIVES: To understand parents' experiences of managing their child's postoperative pain at home. BACKGROUND: Recent changes in children's health care services often shift the responsibility of managing children's postoperative pain to parents. Although pain management is important for good postoperative outcomes, it can be a challenging task for families, and children's pain is often under-managed. DESIGN: This qualitative study used semi-structured interviews to explore parents' experiences of managing their child's postoperative pain at home...
September 2016: Journal of Clinical Nursing
Michele M Carr, Jonathan B Derr, Kodjo Karikari
OBJECTIVE: To determine if decisional regret (DR) in parents following tonsillectomy/adenotonsillectomy (TA) in their children is related to preoperative decisional conflict, perceived outcome of surgery, complications of surgery, or other factors. STUDY DESIGN: Observational analytic cohort study. SETTING: Tertiary care children's hospital. SUBJECTS AND METHODS: Preoperative decisional conflict (DC) and SURE tests were administered to a parent of a child scheduled for TA between July 2014 and July 2015...
June 21, 2016: Otolaryngology—Head and Neck Surgery
Carlton J Zdanski, Grace K Austin, Jonathan M Walsh, Amelia F Drake, Austin S Rose, Trevor G Hackman, Adam M Zanation
OBJECTIVES/HYPOTHESIS: The purpose of this study is to present one of the largest case series of pediatric transoral robotic surgery (TORS) in the upper airway demonstrating a wide range of ages and indications. STUDY DESIGN: A retrospective case series at an academic tertiary referral center from August 2010 to September 2014. METHODS: The da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) was used on 16 pediatric patients for 18 procedures...
June 19, 2016: Laryngoscope
A Patel, N Foden, A Rachmanidou
BACKGROUND: Tonsillectomy is a common, low-risk procedure. Post-tonsillectomy haemorrhage remains the most serious complication. Recent nationwide studies in the UK have identified an increased morbidity and mortality for both high-risk and low-risk elective general surgery performed at the weekend. METHODS: Data for tonsillectomies performed at a district general hospital over a three-year period were retrospectively reviewed. The same group of surgeons performed elective tonsillectomies on both weekends and weekdays...
August 2016: Journal of Laryngology and Otology
Amali Adekwu, Agida Samuel Adoga, Terna Ambrose Gav
BACKGROUND: In 2-4% of all patients requiring adenoidectomy, tonsillectomy or adenotonsillectomy, pre-operative screening tests for coagulation disorders are indicated to detect surgical bleeding complications. However, because of cost effect on the patients, the usefulness of these tests is being challenged. We therefore highlight our experience in paediatric patients undergoing adenoidectomy, tonsillectomy or both in our centre. PATIENTS AND METHODS: This is a 3½-year analysis of the data of 165 paediatric patients who had adenoidectomy, tonsillectomy or both over the study period...
April 2016: African Journal of Paediatric Surgery: AJPS
P W Collins, E Goldman, P Lilley, K J Pasi, C A Lee
Factor XI deficiency is a rare autosomally transmitted coagulopathy that is associated with a variable bleeding tendency. Recently there have been reports of thrombotic events following the administration of a virally inactivated factor XI concentrate (BPL) to factor XI deficient patients. We have therefore reviewed a single centre's experience of the use of factor XI concentrate over a 6-year period and compared this to our previous experience of either no treatment or treatment with fresh frozen plasma (FFP) in 103 patients...
October 1995: Haemophilia: the Official Journal of the World Federation of Hemophilia
Terence S Fu, Andrew Foreman, David P Goldstein, John R de Almeida
BACKGROUND: Squamous cell carcinoma of the head and neck can present as a cervical metastasis from an unknown primary site. Recently, transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) have been incorporated in the workup of unknown primary tumors. METHODS: We searched MEDLINE, EMBASE, Cochrane, and CINAHL from inception to June 2015 for all English-language studies that utilized TORS, TLM, or lingual tonsillectomy in the approach to an unknown primary...
2016: Journal of Otolaryngology—Head & Neck Surgery
J P Windfuhr
BACKGROUND: Tonsillectomy rates vary considerably among different states, regions and times. This study was undertaken to identify the prevalence of "chronic" tonsillitis, peritonsillar abscess, hyperplasia of the tonsils with and without adenoids in absolute and relative numbers in an 80m people nation. Moreover, the number and rates of different surgical procedures to resolve either "chronic" tonsillitis, peritonsillar abscess or upper airway obstruction due to (adeno)tonsillar hyperplasia over several years was evaluated in this study (tonsillectomy, adenotonsillectomy, tonsillotomy , abscess tonsillectomy, transoral incision and drainage)...
April 2016: Laryngo- Rhino- Otologie
J P Windfuhr
BACKGROUND: One of the most significant clinical trials, demonstrating the efficacy of tonsillectomy (TE) for recurrent throat infection in severely affected children, was published in 1984. This systematic review was undertaken to compile various indications for TE as suggested in the literature after 1984 and to stratify the papers according to the current concept of Evidence-based Medicine. MATERIAL AND METHODS: A systematic Medline research was performed using the key word "tonsillectomy" in combination with different filters such as "systematic reviews", "meta-analysis", "English", "German" and "from 1984/01/01 to 2015/05/31"...
April 2016: Laryngo- Rhino- Otologie
J P Windfuhr
BACKGROUND: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disease attributed to children with obsessive compulsive or tic disorders associated with streptococcal infections. Because otolaryngologists evaluate a large number of pediatric patients with recurrent streptococcal infections, tonsillectomy (TE) is a common option of therapy. This study was undertaken to evaluate the efficacy of tonsillectomy in patients presenting with a verified PANDAS...
April 2016: Laryngo- Rhino- Otologie
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