Clinical evaluation of early and delayed post-operative complications following tonsillectomy. A prospective longitudinal observational study.

Background:Tonsillectomy remains one of the most frequently performed ENT procedures, yet postoperative complications continue to influence recovery, patient safety, and resource utilization. Understanding the pattern of early and delayed complications helps refine perioperative practices and improve outcomes. Aim: To evaluate the early and delayed postoperative complications following tonsillectomy and determine their association with demographic and clinical variables. Methods: A prospective observational study was conducted among 50 patients aged 8–30 years undergoing tonsillectomy by the dissection and snare method. Baseline data, preoperative symptoms, tonsillar hypertrophy grade, early complications (≤24 hours), and delayed complications (up to 6 months) were recorded. Statistical analysis was performed using the Chi-square test, with p < 0.05 considered significant. Results: Most participants belonged to the 11–20-year group (74%), and females constituted 56%. Odynophagia (88%) and throat pain (84%) were the most common preoperative symptoms. Grade III tonsillar hypertrophy predominated (46%). Early complications were frequent, with oropharyngeal pain (82%), uvular edema (24%), and referred otalgia (22%) being the most common. Reactive hemorrhage occurred in 6%. Delayed complications included secondary hemorrhage (8%) and infection (6%), while no cases of tonsillar remnants or postoperative voice change were observed. Age showed a significant association with both early and delayed complications (p = 0.04), with higher rates in younger patients. Gender and tonsillar grade showed no statistically significant correlation. Conclusion: Oropharyngeal pain and uvular edema were the predominant early postoperative events, while secondary hemorrhage represented the most frequent delayed complication. Younger age groups exhibited higher susceptibility to postoperative morbidity. Recommendations: Strengthening preoperative counselling for younger patients, standardising analgesic protocols, ensuring meticulous surgical technique, and implementing structured postoperative monitoring may reduce complication rates. Regular auditing of outcomes is recommended to enhance patient safety and refine clinical practice.