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Reduced mouth opening following tonsillectomy in children: myth or reality
Amer Sabih Hydri1, Sher Muhammad Malik
1Department of ENT, Combined Military Hospital, Pano Aqil. draamerhydri@gmail.com
Insights
Tonsillectomy in children may cause temporary mouth opening reduction. However, normal mouth opening (maximum interincisal distance) is typically restored by 26 weeks post-surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Oral and Maxillofacial Surgery
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Concerns exist regarding potential long-term effects on oral function, specifically mouth opening.
Purpose of the Study:
- To investigate the impact of tonsillectomy on mouth opening in children.
- To determine if tonsillectomy leads to a persistent reduction in maximum interincisal distance.
Main Methods:
- A cohort study involving children undergoing tonsillectomy (n=42) and a control group (n=44) undergoing myringotomy or septoplasty.
- Maximum interincisal distance (MID) was measured preoperatively and at 1, 2, 4, 12, and 26 weeks postoperatively.
- Exclusion criteria included pre-operative temporomandibular joint (TMJ) dysfunction and other concurrent surgeries.
Main Results:
- A transient reduction in mouth opening was observed immediately following tonsillectomy.
- By the 26-week postoperative follow-up, 100% of patients in the tonsillectomy group showed a return to their preoperative MID measurements.
Conclusions:
- Reduced mouth opening after pediatric tonsillectomy is a temporary condition.
- Normal mouth opening is typically regained by approximately 26 weeks post-tonsillectomy, indicating no long-term functional deficit.
Objective:
To evaluate whether tonsillectomy in children leads to subsequent reduction in mouth opening.
Study Design:
Cohort study.
Place And Duration Of Study:
Department of ENT/Head and Neck Surgery, Combined Military Hospital, Peshawar, from October 2005 to December 2006.
Methodology:
A total of 42 children undergoing tonsillectomy (Group A = requiring insertion of a mouth gag) and 44 patients undergoing myringotomy or septoplasty (Group B = control group) were included in this cohort double blind study. Patients having pre-operative temporomandibular joint (TMJ) dysfunction, undergoing any other surgery in addition to tonsillectomy e.g. adenotonsillectomy, aged under 4 or above 15 years, and patients lost to follow-up were excluded. Painless, maximum interincisal distance (MID) was measured pre-operatively with a Vernier Calliper. Because of the inconsistency of mouth opening in children, three readings per individual were taken and the maximum recorded. Patients were followed up at 1, 2, 4, 12 and 26 weeks postoperatively in the ENT OPD and respective MID readings recorded.
Results:
After a transient reduction in mouth opening, at the 26th week follow-up, 100% patients had reverted to their preoperative MID measurements.
Conclusion:
Reduced mouth opening in children, after tonsillectomy is a transient finding returning to normal by about the 26th postoperative week.
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