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Published on: November 6, 2019

Effect of tonsillar fossa suturing in adolescents and adults: a systematic review and meta-analysis

Yi-Chan Lee1,2, Li-Jen Hsin3, Yi-Hsuan Lee4

  • 1Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung City, Taiwan.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|June 1, 2026
PubMed

Insights

Tonsillar fossa suturing after tonsillectomy significantly reduces the risk of postoperative hemorrhage (PTH) in adolescents and adults. While pain differences were minimal, suturing offers a safer approach for this higher-risk group.

Area of Science:

  • Otolaryngology
  • Surgical Procedures
  • Evidence-Based Medicine

Background:

  • Tonsillectomy is a common otolaryngology procedure.
  • Postoperative hemorrhage (PTH) and pain are significant concerns, especially in adolescents and adults.
  • The efficacy of tonsillar fossa suturing (TS) in mitigating these complications is debated.

Purpose of the Study:

  • To evaluate the effectiveness of tonsillar fossa suturing (TS) compared to tonsillectomy without suturing (TNS) in reducing postoperative hemorrhage and pain.
  • To analyze outcomes in patients older than 10 years, a population with potentially more severe complications.

Main Methods:

  • A comprehensive literature search was performed across PubMed, Embase, and the Cochrane Library.
  • Included studies compared tonsillectomy with suturing (TS) versus tonsillectomy without suturing (TNS) in patients over 10 years old.
  • A meta-analysis was conducted on the data from seven selected studies involving 3051 patients.

Main Results:

  • Tonsillar fossa suturing (TS) significantly decreased the risk of overall, primary, secondary, and minor postoperative hemorrhage (PTH).
  • No significant difference in major PTH was found between the TS and TNS groups.
  • Lower pain scores were observed in the TS group on postoperative day 7, but pain levels were similar on other days.

Conclusions:

  • Tonsillar fossa suturing (TS) is associated with a reduced risk of postoperative hemorrhage (PTH) in adolescents and adults undergoing tonsillectomy.
  • Pain outcomes require further investigation due to limited data.
  • This meta-analysis provides evidence supporting TS for improved safety in higher-risk patient populations.
Abstract

Keywords:
AdolescentAdultPain, postoperativePostoperative hemorrhageSuturesTonsillectomy

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