Postoperative Complications in Lingual Versus Palatine Tonsillectomies

Area of Science:

• Otolaryngology
• Surgical Outcomes
• Patient Safety

Background:

• Lingual tonsillectomy (LT) is an alternative to palatine tonsillectomy (PT) for certain conditions.
• Understanding the comparative risks of these procedures is crucial for clinical decision-making.

Purpose of the Study:

• To compare the postoperative complication rates of lingual tonsillectomy (LT) versus palatine tonsillectomy (PT).
• To analyze these risks in both adult and pediatric patient populations.

Main Methods:

• Retrospective cohort study using the TriNetX US collaborative network.
• Patients were identified by CPT codes for LT (42870) and PT (42820, 42821, 42825, 42826).
• Propensity score matching was used to compare complication rates within 14 days post-procedure in adult and pediatric subgroups.

Main Results:

• Adults undergoing LT had increased odds of dysphagia (OR=2.6), hospital admission (OR=4.3), and ICU admission (OR=6.1) compared to PT.
• Pediatric patients undergoing LT also showed higher odds of dysphagia (OR=2.4), hospital admission (OR=8.2), and ICU admission (OR=2.7) versus PT.
• No significant difference in bleeding was found between adult LT and PT groups; however, pediatric LT had a lower bleeding rate (1.5%) than pediatric PT (3.2%).

Conclusions:

• Postoperative complications, including dysphagia and need for hospital/ICU admission, are more frequent after lingual tonsillectomy than palatine tonsillectomy in both pediatric and adult patients.
• While bleeding rates were comparable in adults, LT demonstrated a lower risk of postoperative bleeding in the pediatric population compared to PT.