Tonsillectomy has featured highly in recent weeks following the publication of the NAtional randomised controlled Trial of Tonsillectomy IN Adults (‘NATTINA’), which concluded that, compared with conservative management, immediate tonsillectomy is clinically effective and cost-effective in adults with recurrent acute tonsillitis.Reference Wilson, O'Hara, Fouweather, Homer, Stocken and Vale1 The discussion around tonsillectomy is continued in this month's issue of The Journal of Laryngology & Otology.
Post-tonsillectomy haemorrhage should not be underestimated. For example, in the recently published ‘NATTINA’ trial, the most common adverse event was post-operative bleeding (19 per cent haemorrhage rate in adults). Post-tonsillectomy haemorrhage has long been attributed to post-operative infection. However, there is a paucity of evidence to support this hypothesis and the associated use of antibiotics in the current literature. Williamson et al., in this month's issue, systematically review the aetiology, role of infection, as well as the role of antibiotics in post-tonsillectomy haemorrhage.Reference Williamson, Coleman and Douglas2
The World Health Organization recently announced that coronavirus disease 2019 (Covid-19) is no longer a public health emergency of international concern.3 Nonetheless, given the risk of future respiratory virus epidemics and pandemics, it remains vital that we continue to study how viruses spread, the impact of aerosol production and the risk posed by many procedures. Sanmark et al., in this month's issue, measured and compared the aerosol generated between electrocautery and cold steel tonsillectomy.Reference Sanmark, Rantanen, Oksanen, Matvejeff, Möller and Geneid4 The authors found that bipolar electrocautery generated sufficiently higher concentrations of aerosol compared with cold steel dissection. Although a small study, their results support cold dissection as the primary tonsillectomy technique, particularly during epidemics of airborne diseases.
