This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • General Rhinology  • Otolaryngology/ Head & Neck Surgery, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Mary Theresa A. Adams, MD; Michael J. Wilhelm, MD; Sean M. Demars, MD; Wayne J. Harsha, MD

Arch Otolaryngol Head Neck Surg. 2009;135(9):936-939.

Objective  To evaluate the effects of synchronous nasal surgery on the rate of posttonsillectomy hemorrhage.

Design  Retrospective medical record review.

Setting  Military tertiary referral center.

Patients  Adult patients identified in our surgical database from June 1, 2000, through September 31, 2005, who had undergone tonsillectomy or uvulopalatopharyngoplasty with tonsillectomy (UPPPT) either alone or with synchronous nasal surgery.

Main Outcome Measures  The rate of posttonsillectomy hemorrhage was reviewed in all patients who underwent tonsillectomy or UPPPT at our medical center, and an investigation was conducted to determine whether synchronous nasal surgery altered this rate.

Results  A total of 1010 patients were included in this study, with a rate of posttonsillectomy hemorrhage of 5.5%. A total of 204 patients underwent synchronous nasal surgery. No significant difference was found between the hemorrhage rate in patients who underwent tonsillectomy or UPPPT alone and those who underwent synchronous nasal surgery (6.0% and 3.9%, respectively; P = .30). When these patients were further divided into those undergoing UPPPT and those undergoing synchronous nasal surgery, no significant difference in hemorrhage rate was found (6.2% and 2.0%, respectively; P = .06).

Conclusions  Synchronous nasal surgery does not appear to increase the rate of postoperative hemorrhage in patients who undergo tonsillectomy alone or in those who undergo UPPPT. This information may help persuade physicians to perform synchronous surgical procedures instead of staging surgical procedures. In this regard, the patient requires only 1 anesthetic and 1 postoperative course without the risk of increased postoperative hemorrhage.

Author Affiliations: Madigan Army Medical Center, Tacoma, Washington (Drs Adams, Wilhelm, and Harsha); and Bassett Army Community Hospital, Fort Wainwright, Alaska (Dr Demars).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?