Tonsillectomy: Post-Operative Hemorrhage Reduction Strategy in Jos, North Central Nigeria

Area of Science:

• Oto-laryngology
• Surgical Complications
• Hemorrhage Control

Background:

• Post-tonsillectomy hemorrhage (PTH) is a significant life-threatening complication in otolaryngology.
• PTH is a leading cause of malpractice claims in surgical practice.

Purpose of the Study:

• To investigate strategies for reducing post-tonsillectomy hemorrhage (PTH).
• To analyze factors influencing PTH in a specific Nigerian population.

Main Methods:

• Prospective cohort study conducted at Jos University Teaching Hospital, Nigeria.
• Enrolled 96 participants undergoing dissection tonsillectomy ± adenoidectomy under general anesthesia (GA).
• Data analyzed using SPSS, focusing on pre-operative factors, surgical details, and post-operative outcomes.

Main Results:

• A direct correlation was found between tonsil size (Brodsky's grading) and intraoperative blood loss.
• The incidence of primary PTH was 3.1%, with no secondary PTH or mortality observed.
• Key patient features included snoring (86.5%) and nasal obstruction (74.0%).

Conclusions:

• Tonsil size is a critical factor in predicting blood loss, providing new insights for PTH prevention.
• A combination of specific anesthetic agents, surgical expertise, pillar infiltration, awake extubation, and post-operative care contributed to the low PTH incidence.