TONSILLECTOMY AND ADENOTONSILLECTOMY IN SUDANESE PATIENTS

K. SHAMBOUL, Y. M. YOUSIF

Abstract


Objectives: To highlight the indications for and complications of tonsillectomy or
adenotonsillectomy operations in Sudanese patients and to find out whether any correlation
can bededuced between routinely requested pre-operative investigations and thecomplications
which may arise.
Design: A prospective study.
Setting: Khartoum ENT Teaching Hospital, Khartoum, Sudan.
Subjects: One hundred and twenty patients, 55% females and 45% males, age range 3 to 50
years. Pre-operative investigations consisted of a complete blood count and bleeding and
clotting times., AS0 titres and urinalysis.
Interventions: Consisted of tonsillectomy or adenotonsillectomy performed on in-patients by
one of the authors under general anaesthesia.
Main outcome measures: High erythrocyte sedimentation rate (ESR) or AS0 titres should
not deter an indicated tonsillectomy operation which can still be carried out if meticulous
haemostasis is observed.
Results: Three or more episodes of exudative tonsillitis per year and upper airway obstruction
were the commonest indications for tonsillectomy or adenotonsillectomy accounting for
72.5% and 16.7% of the operations. Intra-operative bleeding occurred in 63 (52.5%) of the
patients. Low figures of reactionary and secondary haemorrhages were seen.
Conclusion: It is concluded that as bleeding, both intra- and post-operative is the main
complication of tonsillectomy, its incidence can be reduced to minimal levels by careful
selection of patients, in whom the operation is carried out under general anaesthesia with
gentle handling of tissues and detention of the patients post-operatively for two to three days.
We also found out that coagulation tests need not be routinely requested and reserved for
patients with a history of bleeding tendencies.

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