Advances in Tonsil Surgery, Airway Bleeding Control & Sleep Disorders (Multi-Study Review)

Curated by Dr. Rohan Navelkar  – Recent Advances in ENT

Studies reviewed from Oct–Dec 2024

1. Tranexamic Acid Transforming Tonsillectomy Bleed Management

Source: ENTtoday
Summary from uploaded document: IV tranexamic acid (TXA) protocols significantly decreased takebacks to OT for pediatric post-tonsillectomy hemorrhage.

Across multiple studies this quarter, TXA—whether systemic or topical—showed:

• Reduced intraoperative blood loss

• Shorter operative time

• Better visualization

• Lower re-bleed rates
  
  

Clinical Takeaway:
A unified TXA protocol should be part of every high-volume tonsil surgery center.

2. Tonsillectomy and Systemic Immunity — No Increased COVID-19 Risk

Source: PubMed (Zheng et al.)
Large UK Biobank data showed no increase in COVID susceptibility among adults who had undergone tonsillectomy in childhood.

Takeaway:
Tonsil removal does not impair long-term antiviral immunity.

3. CPAP & Obstructive Sleep Apnea: New Insights Beyond Breathing

Multiple studies highlighted new systemic effects of OSA and CPAP:

a. CPAP reduces risk of retinal disease

OSA patients have higher risk of retinal microvascular complications. CPAP reduced this risk.

b. CPAP improves marital satisfaction & sexual health

OSA affects intimacy; CPAP therapy significantly improved relationship dynamics.

c. AD109 (trial drug) shows promise for OSA

A new combination drug (adenosine A1 agonist + noradrenergic agent) demonstrated effective upper-airway tone improvement.

4. Sleep, Cognition & ENT Links

Two studies this quarter reinforced the ENT–neurology connection:

• Poor sleep correlates with increased dementia risk (Medgami).
  
  

• Sleep disturbances strongly correlate with tinnitus severity (PubMed).
  
  

Clinical takeaway:
Aggressively treating nasal obstruction and OSA is a cognitive-protection strategy, not just respiratory care.

Keywords

Tonsillectomy bleeding TXA protocol, OSA research 2024, CPAP relationship outcomes, sleep tinnitus link, airway surgery advances