Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
Introduction: adenoidectomy and tonsillectomy are very common surgeries in Otolaryngology. However, often they are done without a valuable criterion and indiscriminately. Although in principle the general indications for these interventions are infectious or obstructive procedures, currently its utility is also required by other rare cases as suspected tonsillar malignancy, halitosis of tonsillar origin, IgA nephropathy syndrome and PANDAS (Syndrome Pediatric Autoimmune Neuropsychiatric Disorder associated with Streptococcus). From september 2009, Carlos Andrade Marín Hospital expanded coverage for care in the pediatric population, increasing the number of these surgeries in our Service. The aim of this study was to review the indications and complications of these procedures based on the experience of our service in the pediatric and adult population and to align with international consensus. Materials and methods: a descriptive and retrospective study was conducted using the medical records of patients treated in the Department of Otolaryngology, Carlos Andrade Marín Hospital in the period from may 2010 to december 2012. Demographic data, indications for surgery and complications were analyzed. Results: a total of 120 patients were operated during this period. There was no difference in sex of patients. The average age in adult Tonsillectomy was 26, and in children, 5 years; the mean age in Adenoidectomy was 4.5 years and in cases of combined tonsillectomy and adenoidectomy, the average age was 5 years old. Tonsillectomy was performed in 45% of patients, 30% adenoidectomy, and combined tonsillectomy and adenoidectomy in 25% of cases. The main indication for performing tonsillectomy was recurrent tonsillitis (57% cases), while for adenoidectomy was obstructive adenoid hypertrophy (60% cases). The overall complication rate in tonsillectomy was 11% (6/54); corresponding to 4 cases of early bleeding (7%), and 2 cases of posterior epistaxis by nasotracheal intubation. In adenoidectomy, the overall complication rate was 5% (2/36), 1 case of severe epistaxis, and 1 case by tearing of the nasopharyngeal mucosa that was controlled during surgery. There were no complications in cases of adenoidectomy + combined tonsillectomy. No deaths occurred in either group. Conclusions: adenoidectomy and tonsillectomy are effective surgical procedures and have low rate of complications if they are used according to the criteria established by international consensus. Our surgical experience is accordingly.
Paradise JL. Amigdalectomía y adenoidectomía. En: Chinski A, Sih T, Eavery R (ed.). II Manual de Otorrinolaringología Pediátrica de la IAPO/IFOS. São Paulo 2003. Pp. 122-35. Disponible en línea en: http://www.iapo.org.br/novo/ListaSecao.asp?s=20
Hoddeson EK, Gourin CG. Adult tonsillectomy: current indications and outcomes. Otolaryngol Head Neck Surg. 2009 jan;140(1):19-22
Discolo C, Younes A, Koltai P. Current techniques of adenoidectomy. operative techniques in otolaryngology head and neck surgery, Vol. 12, No 4 (december), 2001: PP 199-203
Aedo C, Muñoz D. Indicaciones no tradicionales de amigdalectomía. Rev. Otorrinolaringol. Cir. Cabeza Cuello 2010; 70: 165
Wilson J, Steen N, Lock C, Eccles M,Carrie S, et.al. Carrie, Ray Clarke, Haytham Kubba, Chris H. Tonsillectomy: A Cost Effective Option for Childhood Sore Throat? Further Analysis of a Randomized Controlled Trial. Otolaryngology Head and Neck Surgery 2012 146: 122
Tomkinson A, Harrison W, Owen D, Harris S, Mc Clure V et al. Risk Factors for Postoperative Hemorrhage Following Tonsillectomy. Laryngoscope 121: february 2011
Amir I, Belloso A, Broomfield S, Morar P. Return to theatre in secondary postonsillectomy haemorrhage: a comparison of coblation and dissection techniques. Eur Arch Otorhinolaryngol (2012) 269:667–671
Cervera Escario J, Del Castillo Martín F, Gómez Campderá JA, et al. Indicaciones de adenoidectomía y amigdalectomía: documento de consenso entre la Sociedad Española de Otorrinolaringología y Patología Cervicofacial y la Asociación Española de Pediatría. Acta Otorrinolaringol Esp. 2006;57:59-65
Piñeiro R, Hijano F, Álvez F, Fernández A, Silva JC et al. Documento de consenso sobre el diagnóstico y tratamiento de la faringoamigdalitis aguda. Anales de Pediatría, Volume 75, Issue 5, Pages 342.e1-342.e13
Leong S, Karkos P, Papouliakos S, Apostolidou M. Unusual complications of tonsillectomy: a systematic review. American Journal of Otolaryngology Head and Neck Medicine and Surgery 28 (2007) 419-422
Windfuhr JP, Schloendorff G, Baburi D, Kremer B. Serious post- tonsillectomy hemorrhage with and without lethal outcome in children and adolescents. International Journal of Pediatric Otorhinolaryngology (2008) 72, 1029-1040
Kay D, Bryson P, Casselbrant M. Rates and Risk Factors for Subsequent Tonsillectomy After Prior Adenoidectomy. ARCH OTOLARYNGOL HEAD NECK SURG/VOL 131, MAR 2005
Mitchell R. Adenoidectomy techniques for sleep disordered breathing. Operative Techniques in Otolaryngology (2005) 16, 229-231
Gallego J, Alvarado R. Hemorragia postadenoamigdalectomía en niños. Acta Pediatr Mex 2006;27(6):333-6
Flores M, De la Torre M, Dávila C, Gía L. Amigdalectomía. Actualización. Servicio de Otorrinolaringología del Hospital Carlos Andrade Marín. Revista integración médica del Colegio Médico de Chimborazo. Volumen 12 Nª3, diciembre 1998
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