Complications of adenotonsillectomy in children under 3 years of age.

Adenotonsillectomy in children may be performed safely on an outpatient basis in the majority of cases without an increase in complication rates. However, very young children comprise a unique patient subpopulation with regard to adenotonsillar surgery. Surgical indications in older children tend to be dominated by chronic recurrent infections, whereas younger children usually require surgery for chronic upper airway obstruction related to adenotonsillar hypertrophy. This study was undertaken to evaluate the adenotonsillectomy patient population under 3 years of age. Complication rates related to airway problems, hemorrhage, and dehydration were determined. Children under 3 years of age demonstrated an increased incidence of postoperative airway complications, manifested by oxygen desaturation and transient upper airway obstruction. It is recommended that adenotonsillectomy be performed on such patients on an inpatient basis with close postoperative monitoring including pulse oximetry.