An Ontario hospital halted tonsil and adenoid surgeries this week after the deaths of two children. A tragic situation which generally occurs in 1 case in 20,000. However, since the pandemic, Quebec has innovated with a new intervention greatly reducing the risk of complications.
McMaster Children’s Hospital in Ontario has suspended scheduled tonsil and adenoid surgeries for patients under 18, after two child deaths. One of them died the day after his operation and the second, nine days after the operation. The exact causes of their death remain unknown. The establishment announced that it is undertaking a complete review of its pediatric program for tonsil and adenoid operations, by external experts. Only emergency pediatric operations on the tonsils and adenoids will be performed.
Each year in Quebec, more than 5,000 operations are performed on children. About 5% of patients bleed after surgery, sometimes requiring a return to the hospital. Most bleeding occurs 7 to 10 days after surgery, says McMaster Hospital. “Unfortunately, tonsillectomy can result in death. It’s rare. It’s on the order of 1 in 20,000,” says the chief of surgery at the Montreal Children’s Hospital, Dr. Sam Daniel. Less than 10 children have died from a complication linked to this surgical procedure over the past 25 years in Quebec. Following the death of little Jade El Rhaib in 2017, at the age of 6, coroner Steeve Poisson recommended that the Ministry of Health and Social Services allocate the necessary resources to develop and implement another tonsillectomy technique.
With the traditional method called extracapsular, “you remove all the tissue from the tonsils,” including that which is against the muscle, which increases the risk of bleeding. The new technique, called intracapsular or partial tonsillectomy, uses a warm probe to remove the tonsil without touching the muscles around it, says Dr. Sam Daniel. The innovative technique reduces the risk of serious complications, such as hemorrhage or death. Studies show that only 0.29% of children return to the hospital due to complications. However, there is a risk that the tonsil will grow back, which may require a second operation. This situation occurs very rarely, says Dr. Daniel.
This new technique also accelerates healing, indicates Dr. Luc Monette, ENT surgeon from Gatineau and president of the Association of Otorhinolaryngology and Cervicofacial Surgery of Quebec from 2018 to 2022. “Children can have a normal diet first thing in the morning, instead of eating a limp, cold diet for 10 to 14 days,” he says. Children can also return to school and play sports five days after surgery, rather than two weeks later.
Dr. Daniel performed the first procedure in Quebec in 2019 at the Montreal Children’s Hospital on a 9-year-old girl. Dr. Neil Bateman from the United Kingdom, a leading authority in the field, was on hand to ensure the operation went smoothly. The same year, Dr. Monette began using this method in Outaouais. Today, around 80% of hospitals have the probes necessary to perform the operation, says Dr. Monette. “Currently, Quebec is innovative. We are the province that has the most hospital centers with this technique. »
