The role of adjuvant therapies and techniques in tonsillectomy

Tonsillectomy is one of the most frequent operations performed worldwide. However, surgical technique and perioperative adjuvent therapies vary greatly. New instruments are constantly being implemented in attempts to decrease the morbitity and operative time of tonsillectomy. Presently, no single surgical technique has been shown by clinical trial to be most effective. Additionally, a myriad of adjuvant therapies used during the perioperative period have been developed to improve outcomes after tonsillectomy. Positive results in randomized controlled trials, with clinical signifigance, have been published recently. Perioperative topical antibiotics and postoperative topical sucralfate decrease postoperative pain; in the intraoperative antiemetics, ondansetron and granisetron, decrease postoperative emesis; intraoperative intravenous dexamethasone decreases postoperative laryngopasm; and postoperative ibuprofin increases posttonsillectomy hemorrage rates. Other adjuvent therapies are also discussed.