Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACGROUND:
Although tonsillectomy is one of the most frequent surgical procedure practiced its indication and operative procedure remains controversial. There is an increased economic pressure to be done as an outpatient procedure . Hemorrhage is main complication other rare complication is asthmatic attacks precipitation in allergic patients.
OBJECTIVE:
To determine the indication. Operative procedure.Complication namely hemorrhage and allergic aggravation
METHODS:
Aretrospective review of T’S under L.A done for 962 patients from june1993-august2008 in Baquba and Sulaiymani teaching hospital partially because of G.Adrug shortage during sanction or because of G.A contra-indication absolutely or relatively .precise block anesthesia of lesser palatine and glossopharyngeal sensory nerve supply to tonsil is practiced with removal of tonsil by dissection
RESULTS:
Most patients operated on because of recurrent acute tonsillitis (926) of these 20 patients with nasal allergy 4patients of them with bronchial asthma, (12)patients with associated cardiac or renal problem, (16)patients with UAO or sleep apnea,(4)patients with enlarged suspected malignancy, (4)patients with peritonsillar abscess, (50)patients developed exaggerated gage reflex but not hindering the operation , (12)patients developed primary bleeding, (2)patients secondary bleeding. None of allergic patients developed asthma during the practice period.
CONCLUSION:
T’S by L.A have a place in surgical practice especially in allergic patients.Allergic aggravation and asthmatic precipitation may be due to G.A and not T’S per se.The operation is of shorter duration and hospitalization than under G.A. Peroperative and secondary bleeding are less than G.A and of less pain severity post-operatively than under G.A.Exaggerated gage reflex not hindering the operation