Related Experiment Video
Updated: Oct 20, 2025
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Tonsil surgery in children under two years of age
1Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK.
Insights
Tonsillectomy in young children for sleep-disordered breathing is increasing. While most recover well, severe complications can occur in the very young and medically complex patients.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Sleep Medicine
Background:
- Increasing rates of tonsillectomy in young children, primarily for sleep-disordered breathing.
- Limited data on the specific risks and outcomes for this age group.
Purpose of the Study:
- To describe the characteristics, indications, and outcomes of tonsillectomy in infants and very young children.
- To identify risk factors for complications in this population.
Main Methods:
- Retrospective review of children aged 1-23 months undergoing tonsillectomy between 2014-2018.
- Analysis of patient demographics, co-morbidities, surgical indications, and post-operative outcomes.
Main Results:
- 157 children (aged 6-23 months) underwent tonsillectomy, representing 3.9% of all pediatric tonsillectomies.
- Sleep-disordered breathing was the primary indication (94%), with 29.9% having co-existing airway lesions.
- 3.8% required emergency pediatric intensive care unit admission, with higher rates in medically complex or younger/smaller children.
Conclusions:
- Most young children experience an uneventful recovery after tonsillectomy, typically with a one-night hospital stay.
- Severe complications, including respiratory issues and intensive care unit admission, are more frequent in medically complex infants and very young children.
Background:
More young children are undergoing tonsillectomy, driven by sleep-disordered breathing concerns. Their specific risks are not well described.
Method:
A retrospective review was conducted of children aged 1-23 months undergoing tonsillectomy at one institution between 2014 and 2018.
Results:
A total of 157 children were identified (3.9 per cent of all tonsillectomies in those aged 0-16 years). Sixty-seven per cent were male. The youngest child was six months old; the smallest weighed 6.9 kg. Sixty-eight (43.3 per cent) had co-morbidities. The indication for tonsillectomy was sleep-disordered breathing in 94 per cent; 29.9 per cent had co-existing airway lesions, mostly laryngomalacia and tracheobronchomalacia. Of the children, 83.4 per cent were managed post-operatively on the surgical ward, and 63.7 per cent stayed 1 night. Emergency paediatric intensive care unit admission occurred in 3.8 per cent. Early respiratory complications and emergency paediatric intensive care unit admission were more common if the patient was medically complex, aged less than 18 months or weighed less than 12 kg. Re-operation for bleeding occurred in 1.9 per cent.
Conclusion:
Most children stay 1 night on a general ward, with an uneventful course. Complications are occasionally severe, mostly in the very young and medically complex.
Related Concept Videos
01:26Tonsillitis II: Management
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
01:23Tracheostomy Suctioning II: Procedure
01:29Suctioning the Nasopharyngeal Airway
Equipment Required