Tonsillectomy Care

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.