POST TONSILLECTOMY HEMMORRHAGE: A NOVEL GRADING SYSTEM dankokong@yahoo.com

 

POST TONSILLECTOMY HEMMORRHAGE: A NOVEL GRADING SYSTEM

7

Nigeria

Oral or Poster

This study was designed to examine certain inherent risks of Tonsillectomy and further propose a grading system for operative blood loss to serve as early warning sign of impending cardiovascular decompensation to initiate prompt resuscitation

Participants who met the criteria for Tonsillectomy ± Adenoidectomy at the Jos University Teaching Hospital, in North Central Nigeria, August, 2017 to July, 2019 were enrolled consecutively and studied.

Ninety-six participants (Male :Female of 1.7:1) were analysed. Their ages ranged from 9months-51years, Median-3.0years while 83(86.5%) were ≤ 18yrs. Clinical features include; Snoring- 83(86.5%), Nasal obstruction-71(74.0%), Noisy breathing -23 (24.0%) and Mouth breathing-18(18.8%), Seventy-Eight (81.2%) were Brodsky’s grade III/IV while 28(29.2%) had deranged INR. Blood loss ranged between 10ml-250ml, Mean=52.7ml ±46.9ml. Bleeding post-operatively of ≥150ml in adults and ≥50ml in Childhood occurred in 5(5.2%). Blood loss was found to have a positive correlation to tonsil volume (mass) with a Correlation coefficient (‘r’) at 99% CI (two-tailed) (r)=.265, (p=.009).

The surgeon should acquaint himself with the risks associated with the procedure to minimize blood loss utilising this blood loss grading system. Knowledge of these seven-pronged blood loss grading system Post Tonsillectomy would alert the physician with early warning signs during surgery for prompt intervention.