Post-operative bleeding in tonsillectomy versus tonsillectomy with fossa closure in a tertiary military hospital: A cohort study

Objective@#To determine the incidence of post-operative bleeding among patients who underwent tonsillectomy alone versus tonsillectomy with fossa closure at the Victoriano Luna Medical Center from January 2015 to December 2017. @*Methods@#Design: Retrospective Cohort Study. Setting: Tertiary Military Hospital. Patients: Medical records of 83 patients that underwent tonsillectomy under the Department of Otorhinolaryngology – Head and Neck Surgery between January 2015 to December 2017 were retrospectively reviewed for data regarding sex, age, tonsillectomy with or without fossa closure and post-operative bleeding. Cases of tonsillectomy alone versus tonsillectomy with fossa closure were compared (particularly with respect to post-operative bleeding), tabulated and statistically analyzed using risk ratio and t-test.@*Results@#There were 57 cases of tonsillectomy alone versus 26 cases of tonsillectomy with fossa closure. The incidence of bleeding in all cases of tonsillectomy whether tonsillectomy alone or with fossa closure was 4.8%. The incidence of bleeding was higher in cases of tonsillectomy with fossa closure at 11.5% (versus 1.8% in tonsillectomy alone). Post-operative bleeding was 0.1 times more likely to occur in patients who underwent tonsillectomy alone than those who underwent tonsillectomy with fossa closure but there was no statistically significant difference in the risk of post-operative bleeding between the two. @*Conclusion@#Although the incidence of bleeding was higher in cases of tonsillectomy with fossa closure, our results suggest that there is no statistically significant difference in risk for postoperative bleeding between tonsillectomy alone or tonsillectomy with fossa closure.

Hypopharyngeal, supraglottic and subglottic stenosis after 1-week intubation

@#Laryngeal stenosis is a partial or complete narrowing of the endolarynx and has many etiologies. Common causes of laryngeal stenosis are iatrogenic (prolonged intubation, laryngeal surgery), external neck trauma, congenital, burns, ingestions, infection, and inflammation (gastroesophageal reflux or Wegener’s). Laryngeal stenosis secondary to trauma usually affects the posterior endolaryngeal region in adults and the subglottic region in children.1 Patients with mild to moderate laryngeal stenosis are usually asymptomatic and if otherwise, majority of the presenting signs and symptoms are mainly related to the airway, feeding and voice resulting to marked respiratory distress, dysphagia/odynophagia and altered voice, respectively. We present a case of hypopharyngeal, supraglottic and subglottic stenosis occurring 1 week after intubation.