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Experiencia de amigdalectomía en la Fundación Hospital de la Misericordia durante los últimos diez años
Tonsillectomy experience in the Foundation "Hospital de la Misericordia Bogota" during the past ten years
Palabras clave:
amigdalectomía, hipertrofia, absceso periamigdalino, insuficiencia velofaríngea. (es)tonsillectomy, hypertrophy, peritonsillar abscess, velopharyngeal insufficiency. (en)
Antecedentes. La amigdalectomía es un procedimiento frecuente en otorrinolaringología pediátrica. Actualmente se indica en hipertrofia amigdalina que obstruya la vía aérea, amigdalitis aguda bacteriana recurrente, asimetría amigdalina y absceso periamigdalino. Es un procedimiento efectivo y con poca morbimor¬talidad. Las complicaciones más frecuentes son dolor, sangrado, intolerancia a la vía oral e insuficiencia velofaríngea.
Objetivo. Revisar la experiencia en amigdalectomía durante los últimos diez años, en la Fundación Hospital de La Misericordia.
Materiales y métodos. Estudio retrospectivo, serie de casos, de pacientes llevados a amigdalectomía desde mayo de 2000 a febrero de 2009 en la Fundación Hospital de La Misericordia. Los resultados fueron analizados con el programa SPSS16.0.
Resultados. Se incluyeron 149 pacientes. Las indicaciones de amigdalectomía fueron hipertrofia amigdalina con obstrucción de vía aérea en 45 por ciento, amigdalitis a repetición e hipertrofia en 27,5 por ciento, amigdalitis a repetición en 11,4 por ciento, y asimetría amigdalina 6,7 por ciento. La técnica quirúrgica utilizada en todos los pacientes fue extracapsular, de éstas el 97 por ciento con electrocauterio monopolar y 3 por ciento con técnica fría. Dentro de las complicaciones postquirúrgicas más frecuentes estuvieron: dolor en 41por ciento, otalgia 12,7 por ciento y sangrado post-operatorio un 4 por ciento. El estudio histopatológico reportó en la mayoría hiperplasia folicular reactiva y un solo caso de linfoma de Burkitt cuya indicación fue asimetría amigdalina. Se encontró mejoría clínica en 96 por ciento de los pacientes.
Conclusión. La amigdalectomía además de ser un procedimiento costo efectivo, es seguro y con escasas complicaciones. Realizada bajo las indicaciones descritas, proporciona un beneficio indiscutible en la calidad de vida y evolución clínica del paciente.
Background. Tonsillectomy is a common procedure in Pediatric Otorhinolaryngology. This procedure is indicated for hypertrophied tonsils that causes airway obstruction, recurrent acute bacterial tonsillitis, asymmetric tonsils and peritonsillar abscess. It is an effective procedure and with little morbimorbidity. The most common complications are pain, bleeding, delay oral intake and velopharyngeal insufficiency.
Objetive. To revise the experience during the last 10 years of tonsillectomy in Fundacion Hospital de La Misericordia.
Materials and methods. Retrospective study, serie of cases, includes all patients who had tonsillectomy from May 2000 to February of 2009 in Fundacion Hospital de La Misericordia. The results were analyzed with the program SPSS16.0.
Results. 149 patients were included in the analysis. Tonsillectomy was indicated for hypertrophied tonsils that causes airway obstruction in 45 percent of patients, recurrent tonsillitis and hypetrophied tonsils in 27,5 percent, recurrent tonsillitis in 11,4 percent, and asymmetric tonsils 6,7 percent. The technique performed in all patients was extracapsular tonsillectomy, using monopolar electrocautery in 97 percent and cold knife in 3 percent. The most common complications were pain in 41 percent, followed by otalgy 12,7 percent and bleeding 4 percent of the patients. The histological examination reported in most of them reactive follicular hyperplasia, except a case of Burkitt lymphoma whose indication was significant tonsillar asymmetry. Clinical improvement was seen in 96 percent of the patients.
Conclusions. Tonsillectomy is a cost-effective and safe procedure. Under certain indications referred in this paper, tonsillectomy improves quality of life and good clinical course.
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Derechos de autor 2009 Revista de la Facultad de Medicina
Esta obra está bajo una licencia Creative Commons Reconocimiento 3.0 Unported.
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