Post-Tonsillectomy Hemorrhage in Pediatric Patients: Comparison of Age Groups and Surgical Techniques

Çelikal Ö., EROĞLU E., Önder Günaydın R.

European Journal of Rhinology and Allergy, vol.6, no.2, pp.48, 2023 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 6 Issue: 2
  • Publication Date: 2023
  • Doi Number: 10.5152/ejra.2023.23091
  • Journal Name: European Journal of Rhinology and Allergy
  • Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.48
  • Keywords: postoperative hemorrhage, surgical techniques, Tonsillectomy
  • Hacettepe University Affiliated: Yes


Objective: Tonsillectomy is a very common operation performed by otolaryngologists. Post-tonsillectomy hemorrhage continues to be a serious complication. The effects of age and surgical technique on this complication are still debated in the literature. The aim of this study was to compare post-tonsillectomy hemorrhage rates among pediatric age groups and different surgical techniques. Methods: Pediatric patients who underwent tonsillectomy were retrospectively analyzed. Four age groups (0-2 years—infancy; ≥ 3-6 years—early childhood; ≥ 7-10 years—middle childhood; ≥ 11-18 years—adolescence) and 3 surgical techniques (Coblation® intracapsular tonsillectomy, Monopolar diathermy, Cold knife dissection) were compared. Results: The mean age of 1371 patients included in the study was 5.9 (standard deviation = 3). Postoperative hemorrhage occurred in 3.7% of patients. In the early childhood period, bleeding was not observed in the Coblation® intracapsular tonsillectomy group, while it was 2% in the monopolar diathermy group and 4.2% in the cold knife dissection group (P =.047). Coblation® intracapsular tonsillectomy and monopolar diathermy groups were determined to be significantly lower bleeding in pre-adolescence and pre-middle childhood periods, respectively (P =.046, P =.011). Statistical difference was not found in hemorrhage rates among age groups in patients upon whom cold knife dissection was used (P =.766). Conclusions: Post-tonsillectomy hemorrhage is associated with pediatric age. The combination of cold and hot techniques makes it difficult to compare the 2 techniques. However, partial tonsillectomy using Coblation® causes less bleeding in pre-adolescence terms.