title: Effects of synchronous nasal surgery on posttonsillectomy hemorrhage.
abstract: OBJECTIVE
  To evaluate the effects of synchronous nasal surgery on the rate of posttonsillectomy hemorrhage.
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  Military tertiary referral center.
  
  
  METHODS
  Adult patients identified in our surgical database from June 1, 2000, through September 31, 2005, who had undergone tonsillectomy or uvulopalatopharyngoplasty with tonsillectomy (UPPPT) either alone or with synchronous nasal surgery.
  
  
  METHODS
  The rate of posttonsillectomy hemorrhage was reviewed in all patients who underwent tonsillectomy or UPPPT at our medical center, and an investigation was conducted to determine whether synchronous nasal surgery altered this rate.
  
  
  RESULTS
  A total of 1010 patients were included in this study, with a rate of posttonsillectomy hemorrhage of 5.5%. A total of 204 patients underwent synchronous nasal surgery. No significant difference was found between the hemorrhage rate in patients who underwent tonsillectomy or UPPPT alone and those who underwent synchronous nasal surgery (6.0% and 3.9%, respectively; P = .30). When these patients were further divided into those undergoing UPPPT and those undergoing synchronous nasal surgery, no significant difference in hemorrhage rate was found (6.2% and 2.0%, respectively; P = .06).
  
  
  CONCLUSIONS
  Synchronous nasal surgery does not appear to increase the rate of postoperative hemorrhage in patients who undergo tonsillectomy alone or in those who undergo UPPPT. This information may help persuade physicians to perform synchronous surgical procedures instead of staging surgical procedures. In this regard, the patient requires only 1 anesthetic and 1 postoperative course without the risk of increased postoperative hemorrhage.
authors.affiliation: Department of Otolaryngology, Madigan Army Medical Center, Tacoma, WA 98431, USA. MaryTheresa.Adams@amedd.army.mil
authors.forename: Mary Theresa A
authors.initials: MT
authors.lastname: Adams
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wilhelm
authors.forename: Sean M
authors.initials: SM
authors.lastname: Demars
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Harsha
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009668:Nose Diseases / Q000175:diagnosis / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010159:Palate / Q000601:surgery; D010614:Pharynx / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011336:Probability; D012016:Reference Values; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods; D014069:Tonsillitis / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery; D055815:Young Adult