TONSILLECTOMY AND ADENOTONSILLECTOMY IN SUDANESE PATIENTS

Objectives: To highlight the indications for and complications of tonsillectomy oradenotonsillectomy operations in Sudanese patients and to find out whether any correlationcan bededuced between routinely requested pre-operative investigations and thecomplicationswhich 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 50years. Pre-operative investigations consisted of a complete blood count and bleeding andclotting times., AS0 titres and urinalysis.Interventions: Consisted of tonsillectomy or adenotonsillectomy performed on in-patients byone of the authors under general anaesthesia.Main outcome measures: High erythrocyte sedimentation rate (ESR) or AS0 titres shouldnot deter an indicated tonsillectomy operation which can still be carried out if meticuloushaemostasis is observed.Results: Three or more episodes of exudative tonsillitis per year and upper airway obstructionwere the commonest indications for tonsillectomy or adenotonsillectomy accounting for72.5% and 16.7% of the operations. Intra-operative bleeding occurred in 63 (52.5%) of thepatients. Low figures of reactionary and secondary haemorrhages were seen.Conclusion: It is concluded that as bleeding, both intra- and post-operative is the maincomplication of tonsillectomy, its incidence can be reduced to minimal levels by carefulselection of patients, in whom the operation is carried out under general anaesthesia withgentle 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 forpatients with a history of bleeding tendencies