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Published on: November 6, 2019
A prospective cohort study exploring the impact of tonsillectomy on feeding difficulties in children
Insights
Tonsillectomy significantly improves paediatric feeding difficulties, particularly fatigue during eating and issues with chewing. This study highlights positive outcomes for children experiencing these common feeding problems.
Area of Science:
- Otolaryngology
- Paediatric Gastroenterology
- Speech-Language Pathology
Background:
- Paediatric feeding difficulties affect up to 25% of children, presenting as food refusal, gagging, choking, and prolonged mealtimes.
- These symptoms are frequently discussed pre-operatively in relation to tonsillectomy.
Purpose of the Study:
- To prospectively investigate the impact of tonsillectomy on paediatric feeding difficulties.
- To assess changes in feeding behaviours using the PediEAT questionnaire post-tonsillectomy.
Main Methods:
- A prospective cohort study involving caregivers of children aged 6 months to 7 years undergoing tonsillectomy.
- The Paediatric Eating Assessment Tool (PediEAT) questionnaire was administered pre- and post-operatively.
- Statistical analysis, including paired student t-tests, was used to compare pre- and post-operative scores.
Main Results:
- 102 children participated; 87% had concurrent adenoidectomy.
- Significant improvements (p < 0.05) were observed in 9 out of 12 PediEAT questions post-tonsillectomy.
- Key improvements noted in 'gets tired from eating' and 'eats food that needs to be chewed' scores.
Conclusions:
- Tonsillectomy is associated with significant improvements in paediatric feeding difficulties.
- Specifically, fatigue during eating and avoidance of masticated foods are likely to improve post-surgery.
- The findings support tonsillectomy as a beneficial intervention for specific feeding issues in children.
Objectives:
Paediatric feeding difficulties are common, affecting up to 25% of otherwise healthy children, symptoms include food refusal, gagging, choking, and excessive mealtime duration. These symptoms are commonly described in pre-operative discussions about tonsillectomy. This prospective study explores the impact of tonsillectomy on paediatric feeding difficulties.
Design:
This prospective cohort study invited caregivers of children undergoing tonsillectomy to complete a PediEAT questionnaire about their children's feeding behaviours, pre and post-operatively. The study was completed in two phases with 9 questions administered in phase 1 and three additional questions added for phase 2. A free text comments box was also provided. Responses were graded from 0 to 5, where 0 is 'never a problem' and 5 is 'always a problem' with eating behaviours.
Setting:
The study was conducted at our institution, a tertiary paediatric ENT unit.
Participants:
Children aged between 6 months - 7 years undergoing tonsillectomy for any indication were invited to participate.
Main Outcome Measures:
Changes to the Pedi-EAT scores pre and post operatively were the main outcome measure.
Results:
102 participants were recruited between January 2020 and January 2022. The mean age of participants was 4.1 years, 87% had a concurrent adenoidectomy. The mean time to completion of post-operative questionnaire was 23 weeks after surgery. 9 of the 12 questions showed a statistically significant improvement in post-operative scores using a paired student t-test (p < 0.05). The most significant improvements related to 'gets tired from eating and is not able to finish' (1.49 pre-op, 0.91 post op, p < 0.01) and 'eats food that needs to be chewed' (1.4 pre-op, 0.72 post-op, p < 0.01). 13% of participants only underwent tonsillectomy and this group also showed a statistically significant improvement in fatigue during eating (p < 0.05).
Conclusion:
Symptoms of fatigue during eating and avoidance of food requiring mastication are most likely to improve following tonsillectomy in children.
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