This paper reviews post-tonsillectomy bleeding in 692 patients and attempts to tease out risk factors. The overall bleed rate of 11.6% seems very high. The return to theatre rate was 2.6%. The paper identifies male patients and adult patients as risk factors. It also suggests that junior surgeons have increased bleed rates. The paper is most remarkable because patients at this institute remain inpatients for eight days and have their tonsillar fossae examined every day and hence the high bleed rate includes any blood staining during the prolonged inpatient stay. It is interesting that more than 10% of post-tonsillectomy patients have some degree of bleeding that is probably not seen in an environment where patients are discharged as day cases or overnight stays. The paper is most fascinating because it highlights the spectacular variations in worldwide practice with patients being admitted for over a week post-tonsillectomy.

Risk factors for post tonsillectomy hemorrhage.
Ryo Ikoma Sayake Sakane, et al.
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Ravi Thevasagayam

Clinical Lead, Department of ENT, Sheffield Children’s Hospital, Sheffield, S10 2TH, UK.

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