[A method for predicting the risk of intraoperative blood loss during tonsillectomy].

Abstract

Chronic tonsillitis remains a common problem among patients seeking an appointment with an otorhinolaryngologist. If there are signs of general intoxication or ineffectiveness of conservative treatment, it is recommended to remove the palatine tonsils as a source of chronic infection. However, due to the abundant blood supply to the palatine tonsils, surgery is associated with a high risk of intraoperative bleeding. The volume of intraoperative blood loss depends on the vascularization of the tonsils, the surgeon's experience and knowledge of the topographic and anatomical features of the operated area. A standard preoperative examination does not involve determining the anatomical boundaries of the palatine tonsils and their blood supply - parameters that affect the intensity of bleeding, and due to the different depth of the tonsils in the tonsillar niches, it is not possible to determine their true dimensions during pharyngoscopy. Modern research highlights the concept of «deep tonsils», when most of the tonsils are located behind the anterior palatine arch, which complicates their removal and increases the duration of the operation. In this study we research the effect of the depth of the tonsils and their vascularization on the volume of intraoperative blood loss. As a result, groups with varying degrees of risk of intraoperative bleeding were identified, depending on the anatomical characteristics of the palatine tonsils.