Role of Steroids Post Tonsillectomy Explored Interview with:
Sayaka Suzuki, MD
Department of Clinical Epidemiology and Health Economics, School of Public Health, Faculty of Medicine, Department of Otolaryngology–Head and Neck Surgery, University of Tokyo, Tokyo, Japan

Medical Research: What are the main findings of the study?

Dr.  Suzuki: We found a slight increase in the risk of severe bleeding requiring surgery for hemostasis in children who were administrated intravenous steroid on the day of tonsillectomy.

Physicians should carefully make a decision to use steroids, taking into account patients’ choice under being well informed on the risks and benefits of steroid use.

Medical Research: What was most surprising about the results?

Dr.  Suzuki: Most notably, there was a discrepancy in the impact of steroids between children and adults.

Tonsillitis in children generally has less severe adhesion to the surrounding tissue compared to that in adults, resulting in less bleeding.

Our study showed a significant impact of steroids on postoperative bleeding only in children.

Medical Research: What should clinicians and patients take away from your report?

Dr.  Suzuki: Physicians should take bleeding risk into account when they use steroids for children, and should give full information on the risks and benefits of steroids to their parents.

Physicians should also provide their parents with alternative treatments for steroids such as antiemetic drugs.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr.  Suzuki: The biological mechanism of steroids for postoperative bleeding should be further investigated.

Suzuki S, Yasunaga H, Matsui H, Horiguchi H, Fushimi K, Yamasoba T. Impact of Systemic Steroids on Posttonsillectomy Bleeding: Analysis of 61 430 Patients Using a National Inpatient Database in Japan. JAMA Otolaryngol Head Neck Surg. 2014;140(10):906-910. doi:10.1001/jamaoto.2014.2009.