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Purpose: To evaluate whether changing trends in tonsil surgery between 2005 and 2017 in Germany were associated with different age- and gender-specific hemorrhage rates. Methods: A longitudinal population-based inpatient cohort study was performed including all patients who had undergone tonsillectomy (with or without adenoidectomy), tonsillotomy, abscess-tonsillectomy, removal of tonsillar remnants and surgical treatment to achieve hemostasis following tonsil surgery. The population was stratified by age (groups of 5 years) and gender. Operation rates were calculated in relation to the end-year population number according to the German Federal Office of Statistics. Results: The surgical rates per 100,000 had significantly decreased from 170.39 to 90.95 (46.62%) in female patients and from 147.33 to 88.19 (40.14%) in male patients within the study period (p < 0.001). A total of 42.352 female patients had required surgical treatment to achieve hemostasis following 783,005 procedures (5.41%). In contrast, only 669,632 operations were performed in male patients but were complicated by hemorrhage in 51.185 cases (7.64%) which was significantly different (p < 0.001). The male-to-female ratio of the surgical rates had increased from 0.86:1 to 0.93:1. Hemorrhage rates differed significantly between age groups (p < 0.001). Male gender is a significant risk factor for bleeding at all ages < 85 years with greatest differences in 20- to 25-year-old patients (12.19% male vs. 6.26% female). Conclusions: Changing trends in tonsil surgery are not associated with increased rates of bleeding complications. Hemorrhage following tonsil surgery is significantly related to age and gender and this should be noted when reported hemorrhage rates in the literature are appraised by the reader. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate trends in hospital admissions in Germany for acute infections of the upper airway and deep neck in the context of the number of tonsil-related surgical procedures between 2005 and 2017. Methods: A retrospective longitudinal population-based cohort study was performed including all unplanned admissions for acute pharyngitis/tonsillitis, abscess formation of the peritonsillar or retropharyngeal/parapharyngeal space. Elective procedures included tonsillectomy (with or without adenoidectomy), secondary tonsillectomy, and tonsillotomy. Emergency operations encompassed abscess-tonsillectomy and transoral drainage procedures of the peritonsillar/parapharyngeal/retropharyngeal space. Results: 553.600 admissions were registered in total with a significant, stepwise increase between 2005 and 2017, including retropharyngeal/parapharyngeal abscess (47.0%), acute tonsillitis (30.8%), acute pharyngitis (26.5%) and peritonsillar abscess (7.9%). There were 1.323.984 elective operations with a significant decrease during the study period. A total of 188.316 emergency operations were done, a significant decrease in the number of abscess-tonsillectomies was compensated by the increased number of transoral peritonsillar abscess drainages. The number of transoral parapharyngeal and retropharygeal abscess drainage procedures did not change significantly (p = 0.846; p = 0.846). Negative correlation was significant between admissions for chronic tonsillitis and emergency admissions (Pearson correlation coefficient = − 0.879, p < 0.001) and also between elective and emergency operations (r = − 0.667; p = 0.013). Conclusions: Concerning infections of the upper airway and deep neck spaces, German Hospitals have to prepare strategies for the increasing challenge by unplanned admissions and emergency operations. Further research is required to clarify whether this phenomenon is caused by the significant decrease in the number of elective operations. [ABSTRACT FROM AUTHOR]

We conducted a retrospective chart review of 85 patients (95% male) with advanced but resectable hypopharyngeal carcinoma to evaluate the effectiveness of an intensified multimodal treatment protocol. This protocol involved concomitant chemo- and radiotherapy before and after total laryngectomy, partial pharyngectomy, and radical neck dissection. Our study population was divided into two groups on the basis of extrasurgical therapy. Group A was made up of 19 patients who had received only postlaryngectomy radiotherapy; 6 of these patients had a stage III tumor and 13 had a stage IV tumor. Group B included 66 patients who had received the intensified treatment; 1 patient had stage II disease, 12 had stage III disease, and 53 had stage IV disease. We found no significant differences in 5-year survival (p = 0.86) or in disease-free interval (p = 0.57) between group A and group B; median survival was 45 and 50 months, respectively. Likewise, when we analyzed the patients in both groups according to tumor stage (stage III vs. stage IV), we found no significant differences in either 5-year survival (group A: p = 0.95; group B: p = 0.18) or disease-free interval (group A: p = 0.74; group B: p = 0.17). We conclude that the prognosis of advanced hypopharyngeal carcinoma remains poor despite treatment with an intensified multimodality protocol. Therefore, the therapeutic strategy should be to individualize treatment with the goal of preserving laryngeal function and optimizing postoperative quality of life. [ABSTRACT FROM AUTHOR]

Gustatory dysfunction is an uncommon complication following tonsillectomy with a potential impact on the quality of life. This retrospective study was undertaken to evaluate the incidence of post-tonsillectomy dysgeusia and its relationship to wound healing and pain. A retrospective chart review of 100 patients who had undergone tonsillectomy between June and December 2008 at a single tertiary care institution was performed. Clinical examination included evaluation of the patient's history and psychophysical testing with cottons soaked with chininsulfate (0.075%; 0.2%), glucose (2%; 10%), citric acid (0.5%; 7.5%) and sodium chloride (0.5%; 2.5%) before, as well as 4 days to 3 months following tonsillectomy at a tertiary care hospital. Anatomical peculiarities, intubation problems, operation time, methods to achieve hemostasis were extracted from the charts. Healing was scored by the physician and pain was scored by the patient. Subjective taste dysfunction was registered in 29 patients 4 days after surgery. In all patients this dysgeusia regressed within weeks. Measured taste function showed lateralized and transient changes. No investigated factor such as pain, operating time, anatomical particularities, wound healing or haemostatic technique were associated with the occurrence of dysgeusia. Transient taste perception changes seem to be relatively frequent after tonsillectomy. Although our results indicate no correlation of even transiently altered taste perception and any of the investigated parameters, this further confirms the clinical impression that gustatory symptoms can occur even after uneventful tonsillectomy. Informed consent should include post-tonsillectomy gustatory dysfunction.

Objective: Although idiopathic sudden sensorineural hearing loss (ISSHL) is a frequent disease in adults, less is known about incidence and treatment of ISSHL in children., Method: A retrospective chart analysis was performed to evaluate the frequency of ISSHL in children aged under 18 years between 2000 and 2003, who were treated in our department. Children received prednisolone intravenously at an initial dose of 3mg/kg bodyweight. Prednisolone dose was reduced to half every second day. The medication was given for a maximum of 14 days or finished 2 days after the hearing normalized in pure-tone audiometry. The follow-up was continued between 3 and 14 months., Results: The complete recovery rate was 57%, and the partial recovery was 36%. Initial hearing loss of 50dB and more was predictive for poor outcome in children (p=0.028). Presence of tinnitus was without relevance for the outcome. The incidence of ISSHL in the local area of about 250,000 inhabitants was 1/10,000 in children., Conclusion: ISSHL seems to be a less frequent disease in children than in adults. Severe initial hearing loss is coupled with poor outcome. Under treatment with prednisolone hearing improvement was found in 13 of 14 patients.