Blood, Sweat, and Tonsils: Bleeding After Abscess Tonsillectomy for Quinsy-A Meta-Analysis

Laryngoscope. 2024 Oct;134(10):4186-4195. doi: 10.1002/lary.31449. Epub 2024 Apr 13.

Abstract

Objective: Abscess tonsillectomy is performed during an active episode of quinsy. Apprehensions regarding an elevated bleeding risk have hindered its widespread acceptance. This study aims to assess the prevalence of post-tonsillectomy bleeding (PTB) associated with abscess tonsillectomy.

Data sources: A search was performed on August 27, 2023 in Medline, Embase, PubMed, Cochrane CENTRAL, and Web of Science databases.

Review methods: The systematic review was conducted in adherence to the PRISMA guidelines. Pooled PTB rate was determined using a meta-analysis of proportions. The JBI tool was used to assess the quality of the included studies.

Results: Of the 525 search records, 18 studies met the eligibility criteria for final analysis. These comprised of retrospective single-center analyses. The pooled prevalence of PTB was 6.65% (95% C.I. 4.01-9.81), and the return-to-theatre rate was 2.35% (95% C.I. 1.48-3.37). There was no difference in PTB rate between unilateral and bilateral tonsillectomy. However, the bipolar technique was associated with a higher PTB rate compared to cold steel dissection. The overall quality of the body of evidence was moderate.

Conclusion: Our study highlights the complications associated with abscess tonsillectomy. These findings contribute valuable insights into this potential treatment option for quinsy.

Level of evidence: N/A Laryngoscope, 134:4186-4195, 2024.

Keywords: abscess tonsillectomy, hemorrhage; infectious/inflammatory, pediatric general, pediatrics; meta‐analysis, systematic review; oropharynx, head and neck; peritonsillar abscess; post‐tonsillectomy bleed; quinsy.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Humans
  • Peritonsillar Abscess* / surgery
  • Postoperative Hemorrhage* / epidemiology
  • Postoperative Hemorrhage* / etiology
  • Prevalence
  • Tonsillectomy* / adverse effects
  • Tonsillectomy* / methods