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Differences in postoperative maladaptive behavioral changes between partial and total tonsillectomy patients.

Yi Cai1, Lindsay Lopata2, Sonam Dodhia3

  • 1Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York, NY, United States; Department of Anesthesiology, Columbia University Medical Center, New York, NY, United States.

International Journal of Pediatric Otorhinolaryngology
|February 16, 2018
PubMed
Summary
This summary is machine-generated.

Children undergoing total tonsillectomy experience more postoperative maladaptive behavioral changes (PMBCs) than those having partial tonsillectomy, despite similar pain levels. Further research is needed to explore these behavioral differences.

Keywords:
BehaviorMaladaptive behavioral changesPartial tonsillectomyPediatricPostoperative painTonsillectomyTonsillotomy

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Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Behavioral Pediatrics

Background:

  • Sleep-disordered breathing (SDB) is linked to behavioral difficulties that often improve after tonsillectomy.
  • Tonsillectomy can lead to short-term postoperative maladaptive behavioral changes (PMBCs).
  • A comparison of PMBCs between total and partial tonsillectomy has not been previously studied.

Purpose of the Study:

  • To compare the incidence and severity of PMBCs in pediatric patients undergoing total versus partial tonsillectomy.
  • To assess the relationship between tonsillectomy type and postoperative behavioral outcomes.

Main Methods:

  • Seventy-eight children (aged 1-6 years) with SDB undergoing tonsillectomy were enrolled.
  • Parental surveys using the Post-Hospital Behavior Questionnaire (PHBQ) were conducted at 48-72 hours and 1-2 weeks postoperatively.
  • Postoperative pain was assessed using the Parents' Postoperative Pain Measure (PPPM), and data were analyzed using t-tests and Chi-squared tests.

Main Results:

  • Total tonsillectomy patients exhibited higher PHBQ scores at both postoperative time points compared to partial tonsillectomy patients (p=0.013).
  • PMBCs were more frequent in total tonsillectomy patients (76% at 2-3 days, 28% at 1-2 weeks) versus partial tonsillectomy patients (59% at 2-3 days, 7% at 1-2 weeks).
  • Pain level distributions were similar between the two surgical groups.

Conclusions:

  • Total tonsillectomy is associated with a higher incidence of PMBCs compared to partial tonsillectomy.
  • These behavioral changes occur despite comparable postoperative pain levels between the surgical groups.
  • Further investigation into the reasons for increased PMBCs after total tonsillectomy is warranted.