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Article Type

Article

Abstract

Back ground and objectives: Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Tonsillar pathology may be associated with nasal problems which indicate the nasal surgical intervention. There are two opinions , one is preferred the nasal surgery first and then after 3-6 months the tonsillectomy can be done , while the other claimed that the both surgical procedures can be done at same time safely without any increasing in the risk of postoperative complications .

Therefore this study was conducted prospectively to confirm that there is no significant difference regarding the incidence of the postoperative complication and the period of hospitalization if the tonsillectomy was performed in combination with nasal surgeries as compared to the tonsillectomy surgery alone.

Patients and methods: 35 patients aged 21-40 years presented at ENT department – Althowra central hospital – Albedya – libya with chronic tonsillitis associated with nasal problems namely deviated nasal septum and hypertrophied inferior turbinates, which was either the main predisposing factor of the chronic tonsillitis or just co-existing problem, who underwent tonsillectomy, in combination with nasal surgery either in form of septoplasty or turbinate surgery as group –A, and was compared to group –B which included 50 patients of same age group who were operated by tonsillectomy only , and in both groups the sampling was by simple random distribution. The both groups compared in relation to operative time consumption, intra operative bleeding, postoperative dysphagia and odynophagia, postoperative oral intake, vomiting tendency, referred otalgia, fever, otitis media, septicemia, airway obstruction; the period of postoperative hospitalization and healing process.

Results: 80% of patients of group –A showed non-significant intra operative and postoperative bleeding, non-significant dysphagia, odynophagia, referred otalgia, fever, and vomiting tendency as compared to group –B with percentage of 82% who showed same results. 96% of patients of group-A stayed less than 24 hours postoperatively in hospital as compared to group-B in which 98% stayed same period in the hospital after surgery. Regarding otitis media, airway obstruction and septicemia, in the both groups no cases were registered. The local throat healing process after both procedures completed by one week.

Conclusion: Generally speaking combined tonsillectomy and nasal surgical procedures, technically appear, safe, and effective, with low economic values and less risk of anesthesia exposure as compared to the other opinion where the patient will go tonsillectomy and after 3-6 months will be operated for the nose which create higher risk of handicapping and complications of the anesthesia and in the same time has higher economic values.

Keywords: Synchronous tonsillectomy and nasal surgery, integrated tonsillectomy and nasal surgery.

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