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CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Weight gain after adenotonsillectomy is more common in young children
David F Smith1, Ami R Vikani, James R Benke
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Insights
Children undergoing adenotonsillectomy (TA) often gain weight post-surgery. Younger children, specifically those 6 years or younger, are more likely to experience significant weight gain after TA for sleep apnea or tonsillitis.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Sleep Medicine
- Pediatric Endocrinology
Background:
- Adenotonsillectomy (TA) is a common procedure for pediatric obstructive sleep apnea (OSA) and recurrent tonsillitis (RT).
- Previous studies indicate a correlation between TA and subsequent weight gain in children.
- Understanding demographic factors influencing this weight gain is crucial for patient management.
Purpose of the Study:
- To investigate demographic factors associated with postoperative weight gain in a large cohort of children undergoing TA.
- To analyze the impact of age, gender, and race on weight changes after adenotonsillectomy.
Main Methods:
- Retrospective chart review of children who underwent TA between 2008 and 2011 at an urban academic center.
- Comparison of demographic data, OSA severity, and normalized Body Mass Index (BMI) z-scores pre- and post-surgery.
- Statistical analysis, including multiple linear regression, to identify predictors of weight gain.
Main Results:
- Weight data were available for 115 children; 85 underwent surgery for OSA.
- Overall BMI z-scores increased significantly post-TA (0.98 to 1.21, P = .0009).
- Younger age (≤ 6 years) was a significant negative predictor of BMI z-score change (P = .015), indicating greater weight gain in younger children.
Conclusions:
- Consistent with prior research, children experience weight gain following adenotonsillectomy.
- Younger age is a significant predictor of increased postoperative weight gain.
- Prospective studies are recommended to further explore the relationship between demographic factors, particularly age, and weight gain after TA.
Objective:
Adenotonsillectomy (TA), performed for obstructive sleep apnea (OSA) or recurrent tonsillitis (RT), has been associated with weight gain after surgery. The objective of this study was to look at a large population of children undergoing TA and the demographic factors that contribute to postoperative weight gain.
Study Design:
Case series with retrospective chart review.
Setting:
Tertiary, urban academic care center.
Subjects And Methods:
Children undergoing TA at an academic center between 2008 and 2011 were included in this study. Demographic data (age, gender, race), OSA disease severity, preoperative and 3- to 6-month postoperative normalized body mass index (BMI; z-scores), and changes in z-scores were compared.
Results:
Complete weight data after TA were available for 115 children, 85 of whom underwent surgery for OSA. Mean age (7.2 ± 4.3 vs 7.3 ± 4.4 years, P = .955) and gender distribution (38% female vs 50% male; P = .323) were similar for the OSA and RT groups. However, children with OSA were more likely to be black (60% vs 33%) than RT patients (P = .026). Overall, the preoperative BMI z-score increased from 0.98 ± 1.50 to 1.21 ± 1.25 (P = .0009) with no difference by surgical indication (P = .58). Multiple linear regression analysis demonstrated that only age was significantly, and negatively, associated with changes in BMI z-scores (P = .015).
Conclusions:
Similar to previous studies, children had weight gain after TA. In this analysis, younger age (≤ 6 years) was a significant predictor of postoperative weight gain. Future research should prospectively evaluate the association between weight gain and demographic factors in children undergoing TA, with special attention to the relationship with age.
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