Serious Complications following Tonsillectomy: How Frequent Are They Really?Windfuhr J.P.
Department of Otorhinolaryngology, Plastic Head and Neck Surgery, Kliniken Maria Hilf, Mönchengladbach, Germany
Introduction: Quality assurance in health care involves the evaluation of outcomes, cost-benefit ratios, and access to the delivery system. This literature review was undertaken to clarify the incidence of serious posttonsillectomy complications to better understand the outcome component of quality assurance. Material and Methods: A Medline review was undertaken using the key word ‘tonsillectomy' AND each of the following: ‘serious', ‘complications' and ‘review'; ‘meta-analysis', ‘Cochrane'; ‘life-threatening', ‘death' and ‘disability'. Results: 454 articles were identified with the following search items in combination with ‘tonsillectomy': ‘serious' (154), ‘complications', ‘review' (24), ‘meta-analysis' (38), ‘Cochrane' (43), ‘life-threatening' (87), ‘death' (91), ‘disability' (17). Sixty-seven articles described a complication rate and were therefore eligible for review: 22 case reports, 9 case series, 2 questionnaires and 33 studies with a more or less precise complication rate were obtainable. Most articles (n = 30) reported the rate of posttonsillectomy hemorrhage with a considerable range. Fifteen articles reported the incidence of death, which ranged from 1:7,132 to 1:170,000 and almost always resulted from excessive hemorrhage. All other complications were mentioned in case reports. Conclusion: The most common postoperative complication of tonsillectomy is bleeding. However, the incidence varies considerably across studies depending on the study design, follow-up and definition of postoperative bleeding. Other serious adverse events, such as neurological disabilities, emphysema (with or without pneumomediastinum), or vascular problems outside the neck are infrequent.
Jochen P. Windfuhr, MD
Department of Otorhinolaryngology, Head and Neck Surgery, Kliniken Maria Hilf
DE-41061 Mönchengladbach (Germany)
Published online: August 22, 2013
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 3, Number of References : 89
ORL (Journal for Oto-Rhino-Laryngology, Head and Neck Surgery)
Vol. 75, No. 3, Year 2013 (Cover Date: August 2013)
Journal Editor: O'Malley Jr. B.W. (Philadelphia, Pa.)
ISSN: 0301-1569 (Print), eISSN: 1423-0275 (Online)
For additional information: http://www.karger.com/ORL