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  11. A Scoping Review Of Recurrent Post-tonsillectomy Hemorrhage In Children

A Scoping Review of Recurrent Post-Tonsillectomy Hemorrhage in Children

Kathleen R Billings1,2, Saied Ghadersohi1,2, Andrea J Fawcett3

  • 1Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.

The Laryngoscope
|December 8, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Recurrent post-tonsillectomy hemorrhage (PTH) in children lacks identified risk factors. Further research is needed for standardized definitions and predictive screening protocols for this common surgical complication.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Hemorrhagic Disorders

Background:

  • Tonsillectomy is a common pediatric surgical procedure.
  • Post-tonsillectomy hemorrhage (PTH) is a known complication.
  • Recurrent PTH incidence and risk factors require further investigation.

Purpose of the Study:

  • To analyze the incidence and risk factors for recurrent post-tonsillectomy hemorrhage (PTH) in children.
  • To map existing evidence and identify knowledge gaps regarding recurrent PTH.

Main Methods:

  • A scoping review following PRISMA-ScR guidelines.
  • Included studies reporting incidence of primary and recurrent PTH in pediatric tonsillectomy cases.
  • Data synthesized from 11 manuscripts detailing 229 recurrent PTH episodes.
Keywords:
pediatric patientspost‐operative bleedingpost‐tonsillectomy hemorrhagetonsillectomy

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Main Results:

  • Recurrent PTH occurred in 7.1% of initial PTH cases (0.33% of all tonsillectomies).
  • No clear associations found between oropharyngeal findings, initial management, tonsillectomy indication, NSAID use, or surgical technique and recurrent PTH.
  • Significant heterogeneity in recurrent bleeding definitions and outcome reporting was noted.

Conclusions:

  • No definitive risk factors for recurrent post-tonsillectomy hemorrhage were identified.
  • Major research gaps include the need for standardized definitions, severity grading, and prospective multicenter data.
  • Systematic evaluation of hematologic screening protocols for recurrent bleeding is warranted.