Tonsillotomy leaves a small, late risk of peritonsillar abscess worth mentioning at consent

The edition in brief

A tertiary paediatric centre reviewed 15 years of tonsil surgery: among 5,576 intracapsular tonsillotomies and 19,834 tonsillectomies, peritonsillar abscess later occurred after 9 tonsillotomies (0.16%) and 1 tonsillectomy (0.005%), on average about eight years after surgery, usually from residual tonsil tissue. The absolute risk is low, but it belongs in the consent conversation and in the differential for a teenager with a history of tonsillotomy and a sore throat. A Thai split-ear randomised trial in 28 adults found intratympanic sodium thiosulfate gel before each cisplatin cycle did not reduce the incidence of ototoxicity by standard criteria, though treated ears lost 7–10 dB less at high frequencies; minor side effects were common. A 100-patient Egyptian trial reported that intravenous magnesium sulphate with weekly cisplatin lowered urinary and serum markers of kidney injury, but did not report clinical renal outcomes. A 30-patient trial found manuka honey sinus irrigation after surgery for allergic fungal rhinosinusitis gave better endoscopic and symptom scores than oral itraconazole, with similar radiological scores. The pearl is the same-day pathway for sudden sensorineural hearing loss.