Journal Reviews
Implications of tonsillectomy in very young children
This is a comprehensive study comprising 157 children who underwent tonsillectomy below the age of two years, mainly for sleep-disordered breathing (86.6%) and recurrent tonsillitis (7%). With relatively recent understanding of OSAS, the indications for tonsillectomy in children under two...
An inherited platelet disorder in a post- tonsillectomy haemorrhage
Unexplained bleeding after any surgery is least desirable and to identify a cause for this preoperatively can be a very useful safeguarding measure. By looking for inherited platelet disorders in patients who bled after tonsillectomy, the authors of this publication...
OSA – do the parents know best?
The difficulty in using the history and examination to determine the severity of sleep disordered breathing in children is well established. The relative prevalence of sleep disordered breathing symptoms in children, and the relative paucity of capacity and restrictive cost...
Platelet-rich plasma to reduce post-tonsillectomy haemorrhage and pain
Minimising haemorrhage and promoting healing of raw areas are cornerstones for uneventful and speedy recovery after tonsillectomy. In this single-blinded prospective experimental study, application of platelet-rich plasma to one side tonsillar bed has been compared to the other side in...
Tonsillectomy in or out?
Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some...
A review of significant issues in the management of obstructive sleep apnoea in children
There are considerable variations in the management of obstructive sleep apnoea in children and this suggests a need for more research and evidence-based information. In this review article, the authors address four key issues. Literature compares tonsillectomy with tonsillotomy, the...
Predicting postoperative respiratory complications following paediatric adenotonsillectomy
This systematic review aimed to compare the presence of clinical features versus the polysomnography results in predicting major postoperative respiratory complications in children undergoing adenotonsillectomy for OSA. The study was prepared according to the PRISMA checklist. Overall 22 studies met...
Post-operative tonsillectomy bleeding with a normal clinical exam
Tonsillectomy is amongst the most common surgical procedures performed across the western world. For patients who report bleeding post-tonsillectomy, but have no clinical findings on examination, the management can be unclear. The accepted current management in most centres would be...
Do tonsillotomies have a higher revision rate than tonsillectomies?
Tonsillotomies have gained popular acceptance in children with sleep-disordered breathing (SDB) in recent years. Short-term advantages that have been shown in the literature include lower haemorrhage rates, shorter operation times and less pain. Evidence for long-term effects are sparse due...
Does ‘weekend effect’ alter post tonsillectomy haemorrhage rates?
Staffing levels are generally low over the weekends and senior physicians are less easily available. It is generally believed that this affects patients undergoing high-risk surgery. Whether doing tonsillectomy at weekends adds to the risks of post tonsillectomy haemorrhage is...
A comparison of cold dissection, coblation and diode laser tonsillectomy
Excellence in tonsillectomy is based on the time taken, blood loss and rapid recovery with minimal pain. In this study, 120 children underwent tonsillectomy by three methods, namely cold dissection, coblation and diode laser dissection in three randomly allocated groups...
Influence of atmospheric conditions on post tonsillectomy secondary haemorrhage
Haemostasis in epistaxis and a good few other conditions outside the field of otolaryngology seem to be affected by the weather. It is generally thought that dry and hot environment encourages secondary post tonsillectomy haemorrhage. Variations in water vapour pressure,...
