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Tonsillectomy and the incidence of various types of cancer. Immunol Res 2021; 69:467-470. [PMID: 34523058 PMCID: PMC8580919 DOI: 10.1007/s12026-021-09230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/28/2021] [Indexed: 11/03/2022]
Abstract
A potential connection between tonsillectomy and the development of various cancer types has repeatedly been reported in the scientific literature, but many studies have contradicted these observations. Thus, we have no clear evidence, neither to firmly support nor to refute the above-mentioned connection. Here, I suggest that the main reason for the lack of clearer evidence is that the investigations have so far mainly used incorrect sample groups. I propose that individual differences in the tonsils' involvement in immune reactions should be taken into account to solve this long-standing puzzle.
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Chung SA, Han MR. Pupil-Involving Oculomotor Nerve Palsy Following Tonsillectomy and Adenoidectomy. J Pediatr Ophthalmol Strabismus 2019; 56:e76-e78. [PMID: 31821512 DOI: 10.3928/01913913-20190917-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/25/2019] [Indexed: 11/20/2022]
Abstract
Ocular complications of adenotonsillectomy are rare. The authors describe a 6-year-old boy who developed mydrasis and limitations of supraduction and infraduction after adenotonsillectomy. This was attributed to the hemorrhagic compression of the nerve in the cavernous sinus. This is the first report of pupil-involving oculomotor nerve palsy following adenotonsillectomy. [J Pediatr Ophthalmol Strabismus. 2019;56:e76-e78.].
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Soldatova L, Doty RL. Post-tonsillectomy taste dysfunction: Myth or reality? World J Otorhinolaryngol Head Neck Surg 2018; 4:77-83. [PMID: 30035265 PMCID: PMC6051494 DOI: 10.1016/j.wjorl.2018.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 02/28/2018] [Indexed: 11/17/2022] Open
Abstract
Lingual branches of the glossopharyngeal nerve (CN Ⅸ) are at risk of injury during tonsillectomy due to their proximity to the muscle layer of the palatine tonsillar bed. However, it is unclear how often this common surgery leads to taste disturbances. We conducted a literature search using PubMed, Embase, Cochrane Library, Google Scholar, PsychInfo, and Ovid Medline to evaluate the available literature on post-tonsillectomy taste disorders. Studies denoting self-reported dysfunction, as well as those employing quantitative testing, i.e., chemogustometry and electrogustometry, were identified. Case reports were excluded. Of the 8 original articles that met our inclusion criteria, only 5 employed quantitative taste tests. The highest prevalence of self-reported taste disturbances occurred two weeks after surgery (32%). Two studies reported post-operative chemical gustometry scores consistent with hypogeusia. However, in the two studies that compared pre- and post-tonsillectomy test scores, one found no difference and the other found a significant difference only for the left rear of the tongue 14 days post-op. In the two studies that employed electrogustometry, elevated post-operative thresholds were noted, although only one compared pre- and post-operative thresholds. This study found no significant differences. No study employed a normal control group to assess the influences of repeated testing on the sensory measures. Overall, this review indicates that studies on post-tonsillectomy taste disorders are limited and ambiguous. Future research employing appropriate control groups and taste testing procedures are needed to define the prevalence, duration, and nature of post-tonsillectomy taste disorders.
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Al-Amery SM, Nambiar P, Naidu M, Ngeow WC. Variation in Lingual Nerve Course: A Human Cadaveric Study. PLoS One 2016; 11:e0162773. [PMID: 27662622 PMCID: PMC5035068 DOI: 10.1371/journal.pone.0162773] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/29/2016] [Indexed: 11/18/2022] Open
Abstract
The lingual nerve is a terminal branch of the mandibular nerve. It is varied in its course and in its relationship to the mandibular alveolar crest, submandibular duct and also the related muscles in the floor of the mouth. This study aims to understand the course of the lingual nerve from the molar area until its insertion into the tongue muscle. This cadaveric research involved the study of 14 hemi-mandibles and consisted of two parts: (i) obtaining morphometrical measurements of the lingual nerve to three landmarks on the alveolar ridge, and (b) understanding non-metrical or morphological appearance of its terminal branches inserting in the ventral surface of the tongue. The mean distance between the fourteen lingual nerves and the alveolar ridge was 12.36 mm, and they were located 12.03 mm from the lower border of the mandible. These distances were varied when near the first molar (M1), second molar (M2) and third molar (M3). The lingual nerve coursed on the floor of the mouth for approximately 25.43 mm before it deviated toward the tongue anywhere between the mesial of M1 and distal of M2. Thirteen lingual nerves were found to loop around the submandibular duct for an average distance of 6.92 mm (95% CI: 5.24 to 8.60 mm). Their looping occurred anywhere between the M2 and M3. In 76.9% of the cases the loop started around the M3 region and the majority (69.2%) of these looping ended at between the first and second molars and at the lingual developmental groove of the second molar. It gave out as many as 4 branches at its terminal end at the ventral surface of the tongue, with the presence of 2 branches being the most common pattern. An awareness of the variations of the lingual nerve is important to prevent any untoward complications or nerve injury and it is hoped that these findings will be useful for planning of surgical procedures related to the alveolar crest, submandibular gland/ duct and surrounding areas.
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Affiliation(s)
- Samah M Al-Amery
- Dept. of Oro-Maxillofacial Surgical and Medical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Phrabhakaran Nambiar
- Dept. of Oro-Maxillofacial Surgical and Medical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Murali Naidu
- Dept. of Anatomy, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Wei Cheong Ngeow
- Dept. of Oro-Maxillofacial Surgical and Medical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Abstract
Oral sensations (i.e., taste, oral somatosensation, retronasal olfaction) are integrated into a composite sense of flavor, which guides dietary choices with long-term health impact. The nerves carrying this input are vulnerable to peripheral damage from multiple sources (e.g., otitis media, tonsillectomy, head injury), and this regional damage can boost sensations elsewhere in the mouth because of central interactions among nerve targets. Mutual inhibition governs this compensatory process, but individual differences lead to variation in whole-mouth outcomes: some individuals are unaffected, others experience severe loss, and some encounter sensory increases that may (if experienced early in life) elevate sweet-fat palatability and body mass. Phantom taste, touch, or pain sensations (e.g., burning mouth syndrome) may also occur, particularly in those expressing the most taste buds. To identify and treat these conditions effectively, emerging clinical tests measure regional vs. whole-mouth sensation, stimulated vs. phantom cues, and oral anatomy. Scaling methods allowing valid group comparisons have strongly aided these efforts. Overall, advances in measuring oral sensory function in health and disease show promise for understanding the varied clinical consequences of nerve damage.
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Affiliation(s)
- Derek J Snyder
- Food Science and Human Nutrition Department, Institute of Food and Agricultural Sciences, University of Florida, 572 Newell Drive, P.O. Box 110370, Gainesville, FL, 32611-0370, USA.
| | - Linda M Bartoshuk
- Food Science and Human Nutrition Department, Institute of Food and Agricultural Sciences, University of Florida, 572 Newell Drive, P.O. Box 110370, Gainesville, FL, 32611-0370, USA
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Hill CA, Thimmappa V, Smith MC, Chen EY. Incidence of Visualization of the Glossopharyngeal Nerve after Pediatric Tonsillectomy. Otolaryngol Head Neck Surg 2015; 154:532-4. [PMID: 26645534 DOI: 10.1177/0194599815620782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/13/2015] [Indexed: 11/16/2022]
Abstract
The objective was to determine the incidence of exposure of the lingual branch of the glossopharyngeal nerve during tonsillectomy with a retrospective review of surgical findings in 138 children who underwent total tonsillectomy at a tertiary medical center. Age, sex, surgical indication, tonsil size, congenital abnormalities, operative time, and surgical findings indicating the presence or absence of the glossopharyngeal nerve in the tonsillar fossa were recorded. Statistical analysis was performed with z test, t test, and Fisher's exact test. Thirty-seven nerves were observed in 28 patients, with preponderance for the left fossa (24 of 37 vs 13 of 37; P = .01). In a comparison of children with and without exposed nerves, there was no statistically significant difference in mean age (6.89 vs 7.08; P = .84), proportion of males (14 of 28 vs 54 of 110; P = 1), or proportion of 3 to 4+ tonsils (20 of 28 vs 73 of 110; P = .66). In approximately 20% of children undergoing tonsillectomy, the lateral pharyngeal musculature incompletely protected the lingual branch of the glossopharyngeal nerve from the tonsil capsule.
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Affiliation(s)
- Courtney A Hill
- Section of Otolaryngology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Vikrum Thimmappa
- Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Mark C Smith
- Section of Otolaryngology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Eunice Y Chen
- Section of Otolaryngology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Lin HC, Hwang MS, Liao CC, Friedman M. Taste disturbance following tongue base resection for OSA. Laryngoscope 2015; 126:1009-13. [PMID: 26343916 DOI: 10.1002/lary.25580] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 06/10/2015] [Accepted: 07/27/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To investigate taste disturbance (TD) following endoscopic coblator open tongue base resection (Eco-TBR) for the treatment of obstructive sleep apnea (OSA)-hypopnea syndrome. STUDY DESIGN A retrospective study in a tertiary academic medical center. METHODS Eighty patients with OSA who failed continuous positive airway pressure therapy and underwent Eco-TBR for the tongue base obstruction were enrolled in this study. Taste changes and complications were examined before and after surgery. The standard three-drop-method gustatory function test was used to study taste status preoperatively and at 7 days, 1 month, and 3 months postoperatively. RESULTS Six female and 74 male patients with OSA (mean age, 42.6 years; mean apnea-hypopnea index, 48.9/hour) had a minimum follow-up of 3 months and complete data available for analysis. One patient had postoperative oral bleeding. No long-term obvious dysphagia was encountered. Twelve patients had obvious TD in the four basic tastes (sweet, sour, salty, and bitter). At 3 months postoperative time, eight patients still had changes in taste sensation; however, the TD severity decreased and did not impact the patients' regular social life. The percentage of taste changes by time after Eco-TBR was between 13.8% and 17.5%. CONCLUSION This study shows Eco-TBR may contribute to postoperative TD. The surgeons should clearly inform the OSA patient about the possibility of TDs after tongue base resection. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Hsin-Ching Lin
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,The Sleep Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Michelle S Hwang
- Department of Otolaryngology Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, U.S.A
| | - Chang-Chuan Liao
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Michael Friedman
- Department of Otolaryngology Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
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Kucur C, Ozbay I, Oghan F, Yildirim N, Zeybek Sivas Z, Canbaz Kabay S. A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome. Case Rep Otolaryngol 2015; 2015:570520. [PMID: 26064747 PMCID: PMC4439494 DOI: 10.1155/2015/570520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/04/2015] [Accepted: 04/09/2015] [Indexed: 11/29/2022] Open
Abstract
Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome) after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1 mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic.
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Affiliation(s)
- Cuneyt Kucur
- Department of Otorhinolaryngology, Dumlupinar University, 43235 Kutahya, Turkey
| | - Isa Ozbay
- Department of Otorhinolaryngology, Dumlupinar University, 43235 Kutahya, Turkey
| | - Fatih Oghan
- Department of Otorhinolaryngology, Dumlupinar University, 43235 Kutahya, Turkey
| | - Nadir Yildirim
- Department of Otorhinolaryngology, Dumlupinar University, 43235 Kutahya, Turkey
| | - Zuhal Zeybek Sivas
- Department of Otorhinolaryngology, Dumlupinar University, 43235 Kutahya, Turkey
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Thiruvenkatarajan V, Van Wijk RM, Rajbhoj A. Cranial nerve injuries with supraglottic airway devices: a systematic review of published case reports and series. Anaesthesia 2014; 70:344-59. [DOI: 10.1111/anae.12917] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2014] [Indexed: 12/12/2022]
Affiliation(s)
- V. Thiruvenkatarajan
- Department of Anaesthesia; The Queen Elizabeth Hospital; Woodville South Australia Australia
- Discipline of Acute Care Medicine; The University of Adelaide; Adelaide South Australia Australia
| | - R. M. Van Wijk
- Department of Anaesthesia; The Queen Elizabeth Hospital; Woodville South Australia Australia
- Discipline of Acute Care Medicine; The University of Adelaide; Adelaide South Australia Australia
| | - A. Rajbhoj
- Department of Anaesthesia; The Queen Elizabeth Hospital; Woodville South Australia Australia
- Discipline of Acute Care Medicine; The University of Adelaide; Adelaide South Australia Australia
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Giannikas C, Pomeranz HD, Smith LP, Fefer Z. Horner syndrome after tonsillectomy: an anatomic perspective. Pediatr Neurol 2014; 51:417-20. [PMID: 25160548 DOI: 10.1016/j.pediatrneurol.2014.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 05/15/2014] [Accepted: 05/16/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Horner syndrome after tonsillectomy has been reported rarely in the literature. Furthermore, postoperative Horner syndrome lasting more than a 1 month is an even more rare occurrence. PATIENT We present a persistent postoperative Horner syndrome in a 5-year-old child following tonsillectomy. RESULTS Clinical diagnosis of Horner syndrome is confirmed pharmacologically, and damage to the oculosympathetic pathway at the level of the superior cervical ganglion is radiographically demonstrated. CONCLUSION Conventional monopolar electrosurgical dissection led to irreversible damage of ganglionic neural tissue at the level of the palatine tonsilar fossa and permanent Horner syndrome.
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Affiliation(s)
- Christina Giannikas
- Department of Ophthalmology, North Shore Long Island Jewish Health System, Great Neck, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York.
| | - Howard D Pomeranz
- Department of Ophthalmology, North Shore Long Island Jewish Health System, Great Neck, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York
| | - Lee P Smith
- Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Division of Pediatric Otolaryngology, Cohen Children's Medical Center, North Shore Long Island Jewish Health System, New Hyde Park, New York
| | - Zipora Fefer
- Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Division of Pediatric Neurology, Cohen Children's Medical Center, North Shore Long Island Jewish Health System, New Hyde Park, New York
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Thiruvenkatarajan V, Van Wijk RM, Elhalawani I, Barnes AM. Lingual nerve neuropraxia following use of the Laryngeal Mask Airway Supreme. J Clin Anesth 2014; 26:65-8. [DOI: 10.1016/j.jclinane.2013.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 10/24/2013] [Accepted: 10/29/2013] [Indexed: 12/19/2022]
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12
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Oda K, Takanashi Y, Katori Y, Fujimiya M, Murakami G, Kawase T. A ganglion cell cluster along the glossopharyngeal nerve near the human palatine tonsil. Acta Otolaryngol 2013; 133:509-12. [PMID: 23294199 DOI: 10.3109/00016489.2012.754997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The lingual branches of the glossopharyngeal nerve were most likely to bring not only gustatory nerves to the postsulcal part of the tongue but also autonomic nerves to the small glands and vessels. Tonsillectomy may injure the ganglion or reduce its function due to scar formation after surgery. OBJECTIVES To determine the topographical anatomy of a suggested ganglion cluster along the lingual branches of the glossopharyngeal nerve and to identify the incidence. METHODS In the human pharynges of 12 donated cadavers, we studied the ganglia using routine procedures for paraffin-embedded histology and immunohistochemistry. RESULTS Near the palatine tonsil, the lingual branches of the glossopharyngeal nerve often contained ganglion cells (in 9 of 12 specimens). The ganglion cells, 20-40 µ in diameter, were sparsely distributed along a 0.5-3.0 mm length of the nerve course attached to the posterolateral aspect of the superior pharyngeal constrictor. Most of these cells were positive for neuronal nitric oxide synthase, while some were positive for tyrosine hydroxylase. Thus, the ganglion was composed of a mixed population of sympathetic and parasympathetic neurons.
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Affiliation(s)
- Kazuha Oda
- Department of Otolaryngology & Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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13
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Windfuhr JP. Serious Complications following Tonsillectomy: How Frequent Are They Really? ACTA ACUST UNITED AC 2013; 75:166-73. [DOI: 10.1159/000342317] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Mathew R, Asimacopoulos E, Walker D, Gutierrez T, Valentine P, Pitkin L. Analysis of Clinical Negligence Claims following Tonsillectomy in England 1995 to 2010. Ann Otol Rhinol Laryngol 2012; 121:337-40. [DOI: 10.1177/000348941212100509] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: We determined the characteristics of medical negligence claims following tonsillectomy. Methods: Claims relating to tonsillectomy between 1995 and 2010 were obtained from the National Health Service Litigation Authority database. The number of open and closed claims was determined, and data were analyzed for primary injury claimed, outcome of claim, and associated costs. Results: Over 15 years, there were 40 claims of clinical negligence related to tonsillectomy, representing 7.7% of all claims in otolaryngology. There were 34 closed claims, of which 32 (94%) resulted in payment of damages. Postoperative bleeding was the most common injury, with delayed recognition and treatment of bleeding alleged in most cases. Nasopharyngeal regurgitation as a result of soft palate fistulas or excessive tissue resection was the next-commonest cause of a claim. The other injuries claimed included dentoalveolar injury, burns, tonsillar remnants, and temporomandibular joint dysfunction. Inadequate informed consent was claimed in 5 cases. Conclusions: Clinical negligence claims following tonsillectomy have a high success rate. Although postoperative bleeding is the most common cause of negligence claims, a significant proportion of claims are due to rare complications of surgery. Informed consent should be tailored to the individual patient and should include a discussion of common and serious complications.
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Renes SH, Zwart R, Scheffer GJ, Renes S. Lingual nerve injury following the use of an i-gel laryngeal mask. Anaesthesia 2011; 66:226-7. [DOI: 10.1111/j.1365-2044.2011.06636.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Heiser C, Landis BN, Giger R, Cao Van H, Guinand N, Hörmann K, Stuck BA. Taste disturbance following tonsillectomy-a prospective study. Laryngoscope 2010; 120:2119-24. [DOI: 10.1002/lary.20971] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Windfuhr JP, Cao Van H, Landis BN. Recovery from long-lasting post-tonsillectomy dysgeusia. ACTA ACUST UNITED AC 2010; 109:e11-4. [PMID: 20123362 DOI: 10.1016/j.tripleo.2009.08.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 08/16/2009] [Accepted: 08/20/2009] [Indexed: 12/29/2022]
Abstract
Transient post-tonsillectomy taste dysgeusia (PTD) is a common complaint. Long-lasting PTD is less frequent but has significant consequences on patients' quality of life, with some cases leading to medicolegal issues. Treatment options and knowledge about mechanisms and factors favoring PTD are limited. PTD may result from direct surgical injury, tongue compression, inflammatory processes or side effects of local anesthetics. Some authors also claim that dietary zinc deficiency plays a role in the development of PTD. Although this latter cause had not yet received a lot of attention, we report a case of a female patient who reported a 4-year PTD and recovered within 2 months after oral intake of zinc sulfate. This clinical observation, together with recent findings on significant improvement of taste disorders after zinc treatments for other causes, opens again the question of what extent zinc deficiency plays a role in PTD.
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Affiliation(s)
- Jochen P Windfuhr
- Department of Otorhinolaryngology and Head and Neck Surgery, Malteser Krankenhaus St. Anna, Duisburg, Germany
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Stathas T, Mallis A, Naxakis S, Mastronikolis NS, Gkiogkis G, Xenoudakis D, Armenakis NS, Goumas PD. Taste function evaluation after tonsillectomy: a prospective study of 60 patients. Eur Arch Otorhinolaryngol 2010; 267:1403-7. [PMID: 20229196 DOI: 10.1007/s00405-010-1224-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Accepted: 02/23/2010] [Indexed: 11/27/2022]
Abstract
Tonsillectomy is regarded as a safe procedure, with post-operative taste disturbances rarely reported. The aim of this study was to access taste function after tonsillectomy in a series of 60 patients. Sixty patients (age range 14-40 years; mean 24.4 years; median 21 years; STD 7.7 years), 24 males and 36 females, underwent bilateral tonsillectomy at the University Hospital of Patras, Greece. All patients were diagnosed with recurrent tonsillitis and randomly assigned to two groups. The first group consisted of 27 patients, who underwent tonsillectomy using scissors and raspatory with electrocautery for coagulation. The remaining 33 patients underwent tonsillectomy using pressure-assisted tissue-welding technology. Chemogustometry was used to evaluate the patients' taste function on the first postoperative day and succeedingly, 15 days and 1 month postoperatively. Three different quantities of tastant were used in each test. Taste recognition in posterior tongue regions proved to be more affected compared with anterior tongue regions in the first postoperative day. Bitter and sour tastes were more affected than those of sweet and salty. Succeeding tests yielded near normal results for all patients except two, with one patient achieving normal taste function 1 month postoperatively and the other still facing taste disorders 1 month after tonsillectomy. The results indicate that Tonsillectomy entails a temporary reduction in taste function. This finding should be attributed to direct or indirect intraoperative damage of the glossopharyngeal nerve or unintentional extension of the lingual nerve by application of the tongue retractor. No significant difference was noted between the two operative techniques evaluated in our study. In most cases taste function returns to preoperative levels within 2 weeks postoperatively. Post-tonsillectomy taste disturbances are uncommon, and patients should be informed of this possibility.
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Windfuhr JP, Sack F, Sesterhenn AM, Landis BN, Chen YS. Post-tonsillectomy taste disorders. Eur Arch Otorhinolaryngol 2009; 267:289-93. [DOI: 10.1007/s00405-009-1057-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 07/20/2009] [Indexed: 11/30/2022]
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