Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective study
Abstract Background Partial Tonsillectomy (PT) is an alternative method to treat sleep disordered breathing (SDB) and/or obstructive sleep apnea (OSA). The current guidelines do not differentiate it from traditional tonsillectomy. Thus, children younger than 3 years old undergoing PT are admitted fo...
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SAGE Publishing
2023-09-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | https://doi.org/10.1186/s40463-023-00659-0 |
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| author | Ameen Biadsee Craig Nathanson Or Dagan Firas Kassem Avishai Stahl Tova Mishali Yaniv Ebner Brian Rotenberg |
| author_facet | Ameen Biadsee Craig Nathanson Or Dagan Firas Kassem Avishai Stahl Tova Mishali Yaniv Ebner Brian Rotenberg |
| author_sort | Ameen Biadsee |
| collection | DOAJ |
| description | Abstract Background Partial Tonsillectomy (PT) is an alternative method to treat sleep disordered breathing (SDB) and/or obstructive sleep apnea (OSA). The current guidelines do not differentiate it from traditional tonsillectomy. Thus, children younger than 3 years old undergoing PT are admitted for surveillance similar to traditional tonsillectomy due to possible postoperative complications. The aim of this study is to assess the risks of PT in children 3 years old and younger, compared to older children. Methods Children underwent inpatient partial tonsillectomy and/or adenoidectomy, due to SDB/OSA, from 2018 to 2020. A special protocol was designed, including follow-up at 2-, 4-, 6-, 8- and 24-h after surgery. Variables analyzed included visual analogue pain score, oral intake, oxygen saturation, pulse rate, postoperative hemorrhage, urine output, temperature, analgesics and fluid administration. Furthermore, major interventions were recorded. Comparison of all variables between children younger than 3 years old with older children was performed. Results Ninety-two children were included; mean age of the whole cohort was 44.5 ± 21.9 months. Thirty-five (38%) children were 3-years old or younger and n = 57 (62%) were older than 3 years old, with no significant statistical difference in sex (p = 0.22). Mean age in the younger group was 25.7 ± 6.9 months, and 56.1 ± 20.1 months in the older group. In total we had 7 children with post-operative complications; 4 with fever, 3 with low intake. There were no major interventions recorded in either group. The complications were more common in the older group (n = 5) than the younger group (n = 2) without a statistical significance (p = 0.59). There were no differences in VAS, use of painkillers, oral intake, urine output, oxygen saturation and tachycardia among the two groups. Conclusion This study supports that children undergoing ambulatory PT may be at low risk of complications, regardless of age. Graphical abstract |
| format | Article |
| id | doaj-art-23ab96c2d78342d3a7ff797d62bcb59e |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2023-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-23ab96c2d78342d3a7ff797d62bcb59e2025-02-03T06:42:37ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162023-09-015211710.1186/s40463-023-00659-0Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective studyAmeen Biadsee0Craig Nathanson1Or Dagan2Firas Kassem3Avishai Stahl4Tova Mishali5Yaniv Ebner6Brian Rotenberg7Department of Otolaryngology–Head and Neck Surgery, Schulich School of Medicine and Dentistry, St. Joseph Hospital, Western UniversityDepartment of Child and Adolescent Psychiatry, Schulich School of Medicine and Dentistry, Western UniversityDepartment of Dermatology and Venereology, Soroka Medical CenterDepartment of Otorhinolaryngology–Head and Neck Surgery, Meir Medical CenterDepartment of Otorhinolaryngology–Head and Neck Surgery, Meir Medical CenterDepartment of Pediatric Surgery, Meir Medical CenterDepartment of Otorhinolaryngology–Head and Neck Surgery, Meir Medical CenterDepartment of Otolaryngology–Head and Neck Surgery, Schulich School of Medicine and Dentistry, St. Joseph Hospital, Western UniversityAbstract Background Partial Tonsillectomy (PT) is an alternative method to treat sleep disordered breathing (SDB) and/or obstructive sleep apnea (OSA). The current guidelines do not differentiate it from traditional tonsillectomy. Thus, children younger than 3 years old undergoing PT are admitted for surveillance similar to traditional tonsillectomy due to possible postoperative complications. The aim of this study is to assess the risks of PT in children 3 years old and younger, compared to older children. Methods Children underwent inpatient partial tonsillectomy and/or adenoidectomy, due to SDB/OSA, from 2018 to 2020. A special protocol was designed, including follow-up at 2-, 4-, 6-, 8- and 24-h after surgery. Variables analyzed included visual analogue pain score, oral intake, oxygen saturation, pulse rate, postoperative hemorrhage, urine output, temperature, analgesics and fluid administration. Furthermore, major interventions were recorded. Comparison of all variables between children younger than 3 years old with older children was performed. Results Ninety-two children were included; mean age of the whole cohort was 44.5 ± 21.9 months. Thirty-five (38%) children were 3-years old or younger and n = 57 (62%) were older than 3 years old, with no significant statistical difference in sex (p = 0.22). Mean age in the younger group was 25.7 ± 6.9 months, and 56.1 ± 20.1 months in the older group. In total we had 7 children with post-operative complications; 4 with fever, 3 with low intake. There were no major interventions recorded in either group. The complications were more common in the older group (n = 5) than the younger group (n = 2) without a statistical significance (p = 0.59). There were no differences in VAS, use of painkillers, oral intake, urine output, oxygen saturation and tachycardia among the two groups. Conclusion This study supports that children undergoing ambulatory PT may be at low risk of complications, regardless of age. Graphical abstracthttps://doi.org/10.1186/s40463-023-00659-0Partial tonsillectomyAdenoidectomyTonsilsSleep disordered breathingMicro-debriderPediatric length of stay |
| spellingShingle | Ameen Biadsee Craig Nathanson Or Dagan Firas Kassem Avishai Stahl Tova Mishali Yaniv Ebner Brian Rotenberg Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective study Journal of Otolaryngology - Head and Neck Surgery Partial tonsillectomy Adenoidectomy Tonsils Sleep disordered breathing Micro-debrider Pediatric length of stay |
| title | Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective study |
| title_full | Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective study |
| title_fullStr | Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective study |
| title_full_unstemmed | Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective study |
| title_short | Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective study |
| title_sort | reconsidering routine admission for children under age 3 undergoing partial tonsillectomy a prospective study |
| topic | Partial tonsillectomy Adenoidectomy Tonsils Sleep disordered breathing Micro-debrider Pediatric length of stay |
| url | https://doi.org/10.1186/s40463-023-00659-0 |
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