Identifying cohort differences in children undergoing partial intracapsular tonsillectomy vs traditional tonsillectomy for sleep disordered breathing
| Autor: | Mark A. Arnold, Haidy Marzouk, Kiranya E. Tipirneni, Jason A. Audlin, Lee Bauter, Erica T. Sher |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty medicine.medical_treatment Clinical Decision-Making Palatine Tonsil 03 medical and health sciences 0302 clinical medicine Postoperative Complications stomatognathic system 030225 pediatrics medicine Intracapsular tonsillectomy Humans Sleep study 030223 otorhinolaryngology Child Asthma Retrospective Studies Tonsillectomy Sleep Apnea Obstructive business.industry Incidence (epidemiology) Patient Selection Age Factors General Medicine medicine.disease Obstructive sleep apnea Otorhinolaryngology Child Preschool Pediatrics Perinatology and Child Health Cohort Female business Body mass index |
| Zdroj: | International journal of pediatric otorhinolaryngology. 137 |
| ISSN: | 1872-8464 |
| Popis: | Partial intracapsular tonsillectomy (PIT) is a well-established technique for reducing post-operative morbidity in pediatric patients with sleep disordered breathing (SDB). Although tonsillar re-growth rates are reported as low, risks of symptom recurrence or need for completion tonsillectomy are clear disadvantages when compared to traditional tonsillectomy (TT). We aim to identify cohort differences to better guide clinical decision making and identify patient-specific factors that may influence this decision. A secondary aim was to evaluate potential risk factors for tonsillar regrowth.Retrospective chart review of pediatric patients who underwent TT or PIT for SDB between 2015 and 2019 at a tertiary care academic medical center. Records were reviewed for age, gender, race, body mass index, comorbidities, diagnosis, apnea-hypopnea index, pre-operative Brodsky tonsil size, length of stay, post-operative hemorrhage, tonsillar regrowth, symptom recurrence, and need for completion tonsillectomy.315 patients were included: 174 underwent TT and 141 underwent PIT. Patients undergoing TT were more likely to have a sleep study showing OSA (OR 3.01, p 0.0001), asthma (OR 4.28, p = 0.000124), and other comorbidities (OR 4.06, p = 0.0258). The overall complication rate was 4.44% (14/315). Tonsillar regrowth was exclusive to the PIT group, occurring in 7/141 patients (4.96%). Age ≤4 years was significantly associated with increased risk of tonsillar regrowth (≤4 years: 7.69%,4 years: 0%; p = 0.049). Race and pre-operative tonsil size were not associated with regrowth.Our study supports the low incidence of tonsillar regrowth in PIT and suggests an association with younger age. Moreover, we found that patients undergoing TT are more likely to be older, have OSA, asthma, and other comorbidities. |
| Databáze: | OpenAIRE |
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