Tonsil surgery in children under two years of age.


Journal

The Journal of laryngology and otology
ISSN: 1748-5460
Titre abrégé: J Laryngol Otol
Pays: England
ID NLM: 8706896

Informations de publication

Date de publication:
Nov 2021
Historique:
pubmed: 17 9 2021
medline: 21 10 2021
entrez: 16 9 2021
Statut: ppublish

Résumé

More young children are undergoing tonsillectomy, driven by sleep-disordered breathing concerns. Their specific risks are not well described. A retrospective review was conducted of children aged 1-23 months undergoing tonsillectomy at one institution between 2014 and 2018. A total of 157 children were identified (3.9 per cent of all tonsillectomies in those aged 0-16 years). Sixty-seven per cent were male. The youngest child was six months old; the smallest weighed 6.9 kg. Sixty-eight (43.3 per cent) had co-morbidities. The indication for tonsillectomy was sleep-disordered breathing in 94 per cent; 29.9 per cent had co-existing airway lesions, mostly laryngomalacia and tracheobronchomalacia. Of the children, 83.4 per cent were managed post-operatively on the surgical ward, and 63.7 per cent stayed 1 night. Emergency paediatric intensive care unit admission occurred in 3.8 per cent. Early respiratory complications and emergency paediatric intensive care unit admission were more common if the patient was medically complex, aged less than 18 months or weighed less than 12 kg. Re-operation for bleeding occurred in 1.9 per cent. Most children stay 1 night on a general ward, with an uneventful course. Complications are occasionally severe, mostly in the very young and medically complex.

Sections du résumé

BACKGROUND BACKGROUND
More young children are undergoing tonsillectomy, driven by sleep-disordered breathing concerns. Their specific risks are not well described.
METHOD METHODS
A retrospective review was conducted of children aged 1-23 months undergoing tonsillectomy at one institution between 2014 and 2018.
RESULTS RESULTS
A total of 157 children were identified (3.9 per cent of all tonsillectomies in those aged 0-16 years). Sixty-seven per cent were male. The youngest child was six months old; the smallest weighed 6.9 kg. Sixty-eight (43.3 per cent) had co-morbidities. The indication for tonsillectomy was sleep-disordered breathing in 94 per cent; 29.9 per cent had co-existing airway lesions, mostly laryngomalacia and tracheobronchomalacia. Of the children, 83.4 per cent were managed post-operatively on the surgical ward, and 63.7 per cent stayed 1 night. Emergency paediatric intensive care unit admission occurred in 3.8 per cent. Early respiratory complications and emergency paediatric intensive care unit admission were more common if the patient was medically complex, aged less than 18 months or weighed less than 12 kg. Re-operation for bleeding occurred in 1.9 per cent.
CONCLUSION CONCLUSIONS
Most children stay 1 night on a general ward, with an uneventful course. Complications are occasionally severe, mostly in the very young and medically complex.

Identifiants

pubmed: 34526169
doi: 10.1017/S0022215121002437
pii: S0022215121002437
doi:

Types de publication

Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1019-1024

Auteurs

O Madej (O)

Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK.

H Kubba (H)

Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK.

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Classifications MeSH