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To the Editor.—Williams and Pope in their article, "Prevention of Primary Tonsil Bleeding," have presented a provocative argument for the preventive management of primary tonsil bleeding by electrocoagulation of parts of the tonsil fossa with subsequent reduction of an incidence of primary bleeding from 2.8% to 0.2% (Arch Otolaryngol, this issue,). They cite Withers et al's incidence of primary and secondary bleeding in 380 tonsillectomies to be 0.8% and 0.8%, respectively. One should note, however, that Withers et al packed the tonsil fossa with a cotton sponge dipped in 1% phenylephrine and tannic acid powder. Fox's series shows an incidence of secondary bleeding in several experimental groups ranging from about 10% to as low as 1.3% in 576 patients who received no vitamin therapy or aspirin. In Bellucci's series of 754 tonsillectomies and adenoidectomies, Bellucci noted that most primary bleeding was from the adenoid bed, whereas the incidence of
CATLIN FI. Tonsillectomy Bleeding. Arch Otolaryngol. 1973;98(5):363. doi:10.1001/archotol.1973.00780020375022
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