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The cold tonsillectomy technique significantly reduces postoperative bleeding compared to hot techniques. Adopting the cold-plus-cold method may improve surgical outcomes and lower complication risks.

Keywords:
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Area of Science:

  • Otolaryngology
  • Surgical Outcomes
  • Public Health

Background:

  • Postoperative bleeding is a significant complication following tonsillectomy.
  • Clinical practice varies nationally regarding surgical techniques, with hot techniques often used despite higher bleeding risks.

Purpose of the Study:

  • To investigate postoperative bleeding rates after tonsillectomy.
  • To analyze the correlation between bleeding rates, patient demographics, and surgical/hemostatic techniques.
  • To compare bleeding rates between Norway and Sweden using national registry data.

Main Methods:

  • Prospective cohort study of 28,254 tonsillectomies (2017-2022).
  • Patients completed 30-day postoperative questionnaires.
  • Multivariate logistic regression analyzed surgical techniques, hemostatic methods, and bleeding events.

Main Results:

  • Overall postoperative bleeding rate was 7.2%, higher in Norway (8.1%) than Sweden (6.3%).
  • Hot+hot technique significantly increased bleeding risk (OR 3.64); cold+cold had the lowest rate.
  • Higher bleeding risks observed in patients aged 19-24 years and males.

Conclusions:

  • The cold-plus-cold technique significantly reduces postoperative bleeding.
  • The cold-plus-hot technique remains prevalent, despite higher risks.
  • Increased adoption of the cold-plus-cold technique could improve tonsil surgery outcomes.