Extensive complication after elective tonsillectomy

Introduction Tonsillectomy is one of the most commonly performed procedures of the head and neck surgery and is one of the routine operations of an ENT doctor. Significant complications such as rebleeding may occur.

Case-report A 22-year-old man with a history of acute recurrent tonsillitis on both sides presented for tonsillectomy. The operation was uncomplicated. Intraoperatively, a left-sided intratonsillar abscess was found. On the first postoperative day, the patient complained of severe sore throats and dysphagia, which improved only moderately with analgesia. On the second postoperative day, the patient woke up with pronounced pressure-thickening submandibular swelling on the left side and aphagia. There was a suspicion of sialadenitis of the submandibular gland. Laboratory tests revealed a leukocytosis and a significant increase in CRP.

Results The MRI scan oft the head and neck revealed abscess formation from the left oropharynx up to the submandibular space. There was an operative revision with abscess drainage parapharyngeal and cervical. Intraoperatively, a large abscess was found in the left submandibular region with a connection to the pharynx. Following pharyngotomy, parenteral nutrition and intravenous antibiotics were subsequently performed.

Conclusion In addition to the occurrence of rebleeding, the present case-presentation aims to point out other serious complications after tonsillectomy. According to the current S2k guideline (therapy of inflammatory diseases of the tonsils - tonsillitis, AWMF), the indication for tonsillectomy should be strictly defined.

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Artikel online veröffentlicht:
10. Juni 2020