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Consequences of adenoidectomy in conjunction with tonsillectomy in children
H J Valtonen1, K E Blomgren, Y H Qvarnberg
1Department of Otorhinolaryngology, Central Hospital of Central Finland, Jyväskylä. hannu.valtonen@kuh.fi
Insights
Adenoidectomy added to tonsillectomy is safe but increases operative time and blood loss, particularly in older children. Careful consideration is advised for children over 10 undergoing tonsillectomy primarily for palatine tonsil disease.
Area of Science:
- Otolaryngology
- Pediatric Surgery
Background:
- Adenotonsillectomy is a common procedure for pediatric airway obstruction and infections.
- The specific role and impact of concurrent adenoidectomy during elective adenotonsillectomy require detailed analysis.
Purpose of the Study:
- To prospectively evaluate the impact of performing adenoidectomy in conjunction with elective adenotonsillectomy in children.
- To assess the changes in operative time, blood loss, and complications associated with adding adenoidectomy.
Main Methods:
- A prospective study included 98 children under 15 undergoing elective adenotonsillectomy over 12 months.
- Adenoidectomy utilized curettes and forceps with mirror visualization; tonsillectomy used unipolar electrodissection.
- Operative duration, intra-operative blood loss, and post-operative complications were meticulously recorded.
Main Results:
- Adenoidectomy constituted approximately 51.8% of the adenotonsillectomy time and 25.9% of total OR time.
- Mean blood loss for adenoidectomy was 43.6 ml, significantly higher than the 7.8 ml for tonsillectomy.
- Increased age correlated significantly with longer adenoidectomy duration and greater blood loss; no post-adenoidectomy complications were observed.
Conclusions:
- While adenoidectomy increases operative time and blood loss, especially in older children, it remains a relatively short and safe procedure.
- The decision to add adenoidectomy to tonsillectomy warrants careful consideration, particularly for children aged 10 and above with primary palatine tonsil disease.
Objective:
The purpose of this prospective study was to investigate the role of adenoidectomy in children undergoing elective adenotonsillectomy.
Patients And Methods:
All consecutive children less than 15 years of age operated on over a 12-month period were included. Adenoidectomy was done with curettes and forceps under mirror visualization and tonsillectomy with a unipolar electrodissection technique. Duration of the operation, intra-operative blood loss, and post-operative complications were recorded.
Results:
Adenotonsillectomy was done in 98 children with a mean age of 7.8 years. The mean duration of adenoidectomy was 10.3 min (S.E. 0.7), 51.8% of the time used for adenotonsillectomy and 25. 9% of the total operating room time. The blood loss was 43.6 ml (S.E. 5.4) and 7.8 ml (S.E. 2.5) for adenoidectomy and tonsillectomy, respectively. Both the duration (P=0.04) and blood loss (P=0.0005) of adenoidectomy increased significantly with the increasing age of children. Post-adenoidectomy complications did not occur.
Conclusion:
Even though adenoidectomy prolonged the operating time and increased the intra-operative blood loss, especially in older children the procedure in general remained relatively short and safe. However, adding adenoidectomy to tonsillectomy should always be carefully considered, particularly in children 10 years or older operated on principally because of palatine tonsil disease.