Adam T Ross1, Ken Kazahaya, Lawrence W C Tom. 1. Department of Otorhinolaryngology-Head and Neck Surgery, The University of Pennsylvania School of Medicine and The Children's Hospital of Philadelphia, 19104, USA.
Abstract
OBJECTIVE: Postoperative same-day discharge is safe for most children undergoing tonsillectomy. However, young children with upper airway obstruction have a higher risk of postoperative complications. We review our tonsillectomy experience in children under 36 months to evaluate the safety of outpatient tonsillectomy in this population. STUDY DESIGN AND SETTING: We conducted a retrospective study of all children under 36 months who underwent tonsillectomy during a recent 2-year period at The Children's Hospital of Philadelphia. RESULTS: The indication for tonsillectomy in 96% of 421 children was upper airway obstruction. Eighteen percent required postoperative treatment to prevent respiratory compromise; 56% of these patients had no associated medical comorbidity. Patients younger than 24 months and those with medical comorbidities were more likely to require intervention. CONCLUSION AND SIGNIFICANCE: It is not possible to preoperatively anticipate which children will have postsurgical complications. We recommend planning an overnight admission for children younger than 36 months undergoing tonsillectomy.
OBJECTIVE: Postoperative same-day discharge is safe for most children undergoing tonsillectomy. However, young children with upper airway obstruction have a higher risk of postoperative complications. We review our tonsillectomy experience in children under 36 months to evaluate the safety of outpatient tonsillectomy in this population. STUDY DESIGN AND SETTING: We conducted a retrospective study of all children under 36 months who underwent tonsillectomy during a recent 2-year period at The Children's Hospital of Philadelphia. RESULTS: The indication for tonsillectomy in 96% of 421 children was upper airway obstruction. Eighteen percent required postoperative treatment to prevent respiratory compromise; 56% of these patients had no associated medical comorbidity. Patients younger than 24 months and those with medical comorbidities were more likely to require intervention. CONCLUSION AND SIGNIFICANCE: It is not possible to preoperatively anticipate which children will have postsurgical complications. We recommend planning an overnight admission for children younger than 36 months undergoing tonsillectomy.
Authors: Claire M Lawlor; Charles A Riley; John M Carter; Kimsey H Rodriguez Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-05-01 Impact factor: 6.223