Reconsidering routine admission for children under age 3 undergoing partial tonsillectomy: a prospective study.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2023-09-23 DOI:10.1186/s40463-023-00659-0

Ameen Biadsee, Craig Nathanson, Or Dagan, Firas Kassem, Avishai Stahl, Tova Mishali, Yaniv Ebner, Brian Rotenberg

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引用次数: 0

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.

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重新考虑接受部分扁桃体切除术的3岁以下儿童的常规入院：一项前瞻性研究。

背景：部分扁桃体切除术（PT）是治疗睡眠呼吸障碍（SDB）和/或阻塞性睡眠呼吸暂停（OSA）的一种替代方法。目前的指导方针并没有将其与传统的扁桃体切除术区分开来。因此，由于可能的术后并发症，接受PT的3岁以下儿童被允许接受类似于传统扁桃体切除术的监测。本研究的目的是评估3岁及以下儿童与年龄较大儿童相比患PT的风险。方法：2018年至2020年，儿童因SDB/OSA接受了住院部分扁桃体切除术和/或腺样体切除术。设计了一个特殊的方案，包括术后2、4、6、8和24小时的随访。分析的变量包括视觉模拟疼痛评分、口服量、血氧饱和度、脉搏率、术后出血、尿量、体温、止痛药和液体给药。此外，还记录了主要干预措施。对3岁以下儿童和年龄较大儿童的所有变量进行了比较。结果：包括92名儿童；整个队列的平均年龄为44.5岁 ± 21.9个月。35名（38%）儿童年龄在3岁或以下 = 年龄大于3岁者57例（62%），性别差异无统计学意义（p = 0.22）。年轻组的平均年龄为25.7岁 ± 6.9个月，56.1 ± 老年组20.1个月。我们总共有7名儿童出现术后并发症；发热4例，低摄入量3例。两组均未记录到重大干预措施。并发症在老年组中更为常见（n = 5）比年轻组（n = 2）无统计学意义（p = 0.59）。两组在VAS、止痛药的使用、口服量、尿量、血氧饱和度和心动过速方面没有差异。结论：本研究支持接受门诊PT的儿童无论年龄大小，并发症的风险都很低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Otolaryngology - Head & Neck Surgery 医学-耳鼻喉科学

CiteScore

6.50

自引率

2.90%

发文量

审稿时长

6 weeks

期刊介绍： Journal of Otolaryngology-Head & Neck Surgery is an open access, peer-reviewed journal publishing on all aspects and sub-specialties of otolaryngology-head & neck surgery, including pediatric and geriatric otolaryngology, rhinology & anterior skull base surgery, otology/neurotology, facial plastic & reconstructive surgery, head & neck oncology, and maxillofacial rehabilitation, as well as a broad range of related topics.