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Surgeons’ preferences and anxiety levels in paediatric adenotonsillectomy: European perspective

Published online by Cambridge University Press:  25 March 2019

A E Kilavuz  and
A A Bayram
A E Kilavuz*
Affiliation:
Department of Otorhinolaryngology, Acibadem Healthcare Group, Maslak Hospital, Acibadem University, Istanbul, Turkey
A A Bayram
Affiliation:
Department of Otorhinolaryngology, Bahcelievler State Hospital, Istanbul, Turkey
*
Author for correspondence: Dr Ahmet Erdem Kilavuz, Department of Otorhinolaryngology, Acibadem Healthcare Group, Maslak Hospital, Acibadem University, Istanbul, Turkey E-mail: [email protected] Fax: +90 212 304 4440
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Abstract

Objective

This study assessed the preferences of surgeons regarding surgical modalities used for adenotonsillectomy, and determined anxiety levels related to the adenotonsillectomy procedure.

Methods

A 10-question survey created by the authors was administered to 413 ENT specialists attending the 4th Congress of Otorhinolaryngology Head and Neck Surgery, held in October 2017 in Barcelona, Spain.

Results

Cold knife dissection was the preferred surgical modality for both adenoidectomy and tonsillectomy. Most participants reported encountering one to five patients with post-tonsillectomy bleeding throughout their entire career. The mean anxiety levels during surgery and the 10-day post-operative period were 3.39 ± 2.14 and 4.18 ± 2.63, respectively (p < 0.05). There was a significant negative correlation between anxiety level and surgeon's experience (p < 0.05).

Conclusion

Cold dissection is still the preferred surgical modality for adenotonsillectomy, while both suture ligation and electrocautery are used for haemostasis. Paediatric adenotonsillectomy is likely to generate anxiety in ENT surgeons, and the possibility of secondary post-tonsillectomy bleeding increases the anxiety levels of surgeons in the post-operative period.

Keywords

AdenoidectomyTonsillectomyAnxietySurgical EquipmentPostoperative Hemorrhage
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 4 , April 2019 , pp. 333 - 338
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr A E Kilavuz takes responsibility for the integrity of the content of the paper

References

1Walner, DL, Mularczyk, C, Sweis, A. Utilization and trends in surgical instrument use in pediatric adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2017;100:8–13Google Scholar
2Randall, DA, Hoffer, ME. Complications of tonsillectomy and adenoidectomy. Otolaryngol Head Neck Surg 1998;118:61–8Google Scholar
3Mitchell, RM, Parikh, SR. Hemostasis in tonsillectomy. Otolaryngol Clin North Am 2016;49:615–26Google Scholar
4Elinder, K, Söderman, AC, Stalfors, J, Knutsson, J. Factors influencing morbidity after paediatric tonsillectomy: a study of 18,712 patients in the National Tonsil Surgery Register in Sweden. Eur Arch Otorhinolaryngol 2016;273:2249–56Google Scholar
5Balch, CM, Freischlag, JA, Shanafelt, TD. Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Arch Surg 2009;144:371–6Google Scholar
6Hinton-Bayre, A, Noonan, K, Ling, S, Vijayasekaran, S. Experience is more important than technology in paediatric post-tonsillectomy bleeding. J Laryngol Otol 2017;131:S35–40Google Scholar
7MacFarlane, PL, Nasser, S, Coman, WB, Kiss, G, Harris, PK, Carney, AS. Tonsillectomy in Australia: an audit of surgical technique and postoperative care. Otolaryngol Head Neck Surg 2008;139:109–14Google Scholar
8Windfuhr, JP, Verspohl, BC, Chen, Y-S, Dahm, JD, Werner, JA. Post-tonsillectomy hemorrhage--some facts will never change. Eur Arch Otorhinolaryngol 2015;272:1211–18Google Scholar
9Lowe, D, van der Meulen, J, Cromwell, D, Lewsey, J, Copley, L, Browne, J et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope 2007;117:717–24Google Scholar
10Cetiner, H, Cavusoglu, I, Duzer, S, Sakallioglu, O, Susaman, N, Yildirim, YSS. Effect of suturation plus Surgicel application on post-tonsillectomy bleeding and pain. J Craniofac Surg 2017;28:e672–5Google Scholar
11Matt, BH, Krol, BJ, Ding, Y, Juliar, BE. Effect of tonsillar fossa closure on postoperative pain and bleeding risk after tonsillectomy. Int J Pediatr Otorhinolaryngol 2012;76:1799–805Google Scholar
12Senska, G, Schröder, H, Pütter, C, Dost, P. Significantly reducing post-tonsillectomy haemorrhage requiring surgery by suturing the faucial pillars: a retrospective analysis. PloS One 2012;7:e47874Google Scholar
13Marrelli, M, Gentile, S, Palmieri, F, Paduano, F, Tatullo, M. Correlation between surgeon's experience, surgery complexity and the alteration of stress related physiological parameters. PloS One 2014;9:e112444Google Scholar
14Wiggins-Dohlvik, K, Stewart, RM, Babbitt, RJ, Gelfond, J, Zarzabal, LA, Willis, RE. Surgeons' performance during critical situations: competence, confidence, and composure. Am J Surg 2009;198:817–23Google Scholar