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Impact of Tonsillectomy on Obesity in Pediatric Patients With Sleep-Disordered Breathing

Rohith S Voora1,2, Daniela Carvalho2,3, Wen Jiang2,3

  • 1School of Medicine, University of California, San Diego, San Diego, California, USA.

OTO Open
|December 6, 2021
PubMed

Insights

Pediatric tonsillectomy for sleep-disordered breathing (SDB) is associated with a significant increase in body mass index (BMI) percentile. This finding highlights the need for obesity management counseling and follow-up for children undergoing this surgery.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Endocrinology
  • Sleep Medicine

Background:

  • Tonsillar hypertrophy and obesity are key contributors to pediatric sleep-disordered breathing (SDB).
  • Tonsillectomy is a common surgical intervention for SDB, addressing airway obstruction.
  • Potential adverse effects of tonsillectomy on pediatric obesity profiles warrant investigation.

Purpose of the Study:

  • To investigate changes in body mass index (BMI) percentile in pediatric patients following tonsillectomy.
  • To analyze the relationship between preoperative and postoperative BMI in children undergoing tonsillectomy for SDB.

Main Methods:

  • Retrospective case series conducted at a tertiary pediatric academic center.
  • Included 1153 pediatric patients undergoing tonsillectomy between January 2016 and December 2016.
  • Utilized generalized regression modeling to analyze BMI percentile changes, considering age, sex, and surgical indication.

Main Results:

  • A significant increase in median BMI percentile was observed post-tonsillectomy (65.8 to 76.4).
  • Higher preoperative BMI percentile, younger age, male sex, and SDB indication correlated with increased postoperative BMI percentile.
  • 48.6% of the cohort had available follow-up BMI data, with a median follow-up of 197 days.

Conclusions:

  • Tonsillectomy is associated with a significant increase in BMI percentile in pediatric patients.
  • A higher proportion of patients were classified as overweight or obese postoperatively.
  • Enhanced preoperative counseling and adjunctive obesity management strategies are recommended for pediatric patients undergoing tonsillectomy.
Abstract

Keywords:
obesitysleep-disordered breathingtonsillectomyweight gain

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