ENT - Tonsillectomy

Question 1

What is the main purpose of a tonsillectomy?

Answer 1

To prevent further episodes of tonsillitis

• 7 or more acute sore throat episodes in 1 year
• 5 per year for 2 years
• 3 per year for 3 years

Question 2

What are other indications for a tonsillectomy?

Answer 2

• Recurrent tonsillar abscesses (2 episodes)
• Enlarged tonsils causing difficulty breathing, swallowing, or snoring

Question 3

What is a common complication after a tonsillectomy?

Answer 3

Sore throat where the tonsillar tissue has been removed
Damage to teeth
Infection
Post-tonsillectomy bleeding
Risks with GA

Question 4

How long can a sore throat last after a tonsillectomy?

Answer 4

Up to 2 weeks

Question 5

What is the main significant complication after a tonsillectomy?

Answer 5

Post tonsillectomy bleeding

Question 6

What percentage of patients experience significant bleeding after a tonsillectomy?

Answer 6

Up to 5%

Question 7

When can significant bleeding occur after a tonsillectomy?

Answer 7

Up to 2 weeks after the operation

Question 8

What are the management steps for post tonsillectomy bleeding?

Answer 8

• Call the ENT registrar
• Get IV access and send bloods
• Keep the patient calm and give analgesia
• Sit them up and encourage spitting out blood
• Make the patient nil by mouth
• Provide IV fluids for maintenance and resuscitation

Can be life-threatening due to aspiration of blood

Question 9

What should be done if there is severe bleeding or airway compromise after tonsillectomy?

Answer 9

Call an anaesthetist; intubation may be required

Question 10

What are the two options for stopping less severe bleeds before going back to theatre?

Answer 10

• Hydrogen peroxide gargle
• Adrenalin soaked swab applied topically