The TYPHOON Study
Research type
Research Study
Full title
The TYPHOON Study: Tonsillectomy Postoperative Haemorrhage Outcomes and Observations National Cohort Study
IRAS ID
345168
Contact name
Catriona Douglas
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
0 years, 2 months, 21 days
Research summary
Tonsillectomy is one of the most commonly performed surgical procedures in Ear, Nose, Throat (ENT) surgery, with an estimated 28 000 procedures performed in the UK 2019/20. Historical data from the UK National Prospective Tonsillectomy Audit in 2005 suggested a post-tonsillectomy bleed (PTB) rate of 4.9% in adults, which has since been widely quoted to patients in the consent taking process. Specifically, the study found a three-times increased risk of PTB with “hot” surgical techniques for both dissection and haemostasis compared to cold steel tonsillectomy without the use of any “hot” techniques. National guidance released halfway through the audit changed practice and reduced rates of haemorrhage. However, data collection for this audit concluded over 20 years ago, and recent unpublished data from Hospital Episode Statistics indicates a significant increase in the PTB rate to 15.6% over the period 2022-2023, the reasons for which are currently unclear and need to be urgently addressed.
We plan to conduct a national, prospective, multicentre collaborative cohort study of all consecutive adult patients undergoing tonsillectomy over 28 days. The study will be run by INTEGRATE, the UK ENT Trainee Collaborative Network, on a voluntary basis. Patients will be expected to fill in a questionnaire on how their sore throat is impacting their quality of life (TOI 14 – Tonsillectomy Outcome Inventory). We will collect granular data on patient characteristics, previous episodes of sore throat, surgical and anaesthetic characteristics and post-operative management including analgesia. We will also telephone the patient at 28 days following surgery to determine if they have had any episodes of bleeding and how this was managed.
The aim of this study is to better understand the risk factors associated with an increased risk of PTB and how we can change our practice to reduce this risk for patients.
REC name
HSC REC B
REC reference
24/NI/0152
Date of REC Opinion
24 Dec 2024
REC opinion
Further Information Favourable Opinion