Overview
Clinical Meaning
Tonsillectomy remains one of the most common surgical procedures in pediatric and adult otolaryngology.
Tonsillectomy remains one of the most common surgical procedures in pediatric and adult otolaryngology. Indications include recurrent acute tonsillitis meeting Paradise criteria (≥7 episodes in 1 year, ≥5/year for 2 years, ≥3/year for 3 years), peritonsillar abscess, obstructive sleep-disordered breathing, and suspected malignancy. Surgical techniques include cold dissection, electrocautery, coblation, and intracapsular (partial) tonsillectomy. Post-operative hemorrhage is the most significant complication, occurring in 2-4% of cases. Post-operative hemorrhage is classified as primary (<24 hours, from inadequate surgical hemostasis) or secondary (5-10 days, from premature eschar separation). The clinician must perform pre-operative risk assessment, prescribe evidence-based perioperative protocols, manage post-operative analgesia according to current guidelines, and coordinate follow-up for complications.
