The Outcomes of Local Injection of Steroids into the Anterior Pillar of the Palatine Tonsil in Pain Control after a Tonsillectomy

Abstract

Objective: To prove the role of local injection of corticosteroids into the anterior pillar of the palatine tonsil in pain control after tonsillectomy. Methods: A prospective study of patients undergoing cold dissection tonsillectomy under general anesthesia in ENT, Head and Neck Surgery Department at Aleppo University Hospital of both sexes and aged 12 years or more during the period from October 2020 to March of 2022. After excision the palatine tonsils and before the patient recovers from general anesthesia, Triamcinolone acetonide at a dose of 40 mg is injected in the anterior pillar of the right palatine tonsil without injecting the anterior pillar of the left palatine tonsil with any medicinal substance to be used as a control. Pain score is compared between the right tonsillar fossa and the left tonsillar fossa after surgery on the first, second, third, fourth, and fifth days. Results: The study included 120 patients, 66 males and 54 females, and the mean age was (17, 12) years. Pain score was assessed in by dividing the pain intensity into four grades: Grade (1) no pain, grade (2) mild, grade (3) moderate, and grade (4) severe. A statistically significant decrease was observed on pain score on the study side compared to the control side during the second, third, fourth and fifth days after surgery (P < 0.05), and no significant difference was observed on pain score between the study side and the control side on the first day after surgery (P > 0.05). Conclusions: Local injection of triamcinolone acetonide into the anterior pillar of the palatine tonsil after tonsillectomy provides good pain relief in the postoperative period.