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Predictors of tonsillectomy after previous adenoidectomy for upper airway obstruction

Eliav Gov-Ari1, Jonathan C Mills, Keith J Basler

  • 1University of Missouri Department of Otolaryngology-Head and Neck Surgery, Columbia, Missouri 65212, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 29, 2011
PubMed

Insights

Pediatric patients with upper airway obstruction undergoing adenoidectomy face higher risks of subsequent tonsillectomy. Young age, female sex, and larger tonsils increase this risk, particularly in those with airway obstruction.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery

Background:

  • Adenoidectomy is a common procedure in children.
  • Upper airway obstruction (UAO) is a frequent indication for adenoidectomy.
  • Tonsillectomy is sometimes performed subsequently, but risk factors are not well-defined.

Purpose of the Study:

  • To identify risk factors for subsequent tonsillectomy after primary adenoidectomy in pediatric patients.
  • To compare subsequent tonsillectomy rates in children with and without UAO undergoing adenoidectomy.

Main Methods:

  • Historical cohort study (1995-2010) of 1291 pediatric adenoidectomy patients.
  • Nested case-control study to analyze predictors of subsequent tonsillectomy.
  • Statistical analysis included Kaplan-Meier, multiple regression, and logistic regression.

Main Results:

  • 7.8% of patients underwent subsequent tonsillectomy.
  • Predictors for tonsillectomy included younger age (<3 years), female sex, and UAO.
  • In the UAO subgroup, larger tonsil size (odds ratio 2.5) predicted subsequent tonsillectomy.

Conclusions:

  • Pediatric adenoidectomy patients with UAO have a higher risk of subsequent tonsillectomy.
  • Young age, female sex, and large tonsil size are significant risk factors for tonsillectomy in this UAO subgroup.
Abstract

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