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Weight Gain in Obese Children After Intracapsular Tonsillectomy
Stephen R Chorney1,2, Rishi Suresh1, Neila Kline1
1Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA.
Insights
Intracapsular tonsillectomy did not significantly alter weight gain in obese children, regardless of obesity class. This suggests the procedure is suitable for treating obstructive breathing in this population.
Area of Science:
- Pediatric Surgery
- Obesity Management
- Otolaryngology
Background:
- Obesity is a growing concern in children, often associated with obstructive breathing issues.
- Intracapsular tonsillectomy is a surgical option for managing obstructive breathing.
- Understanding the impact of this surgery on weight gain in obese children is crucial.
Purpose of the Study:
- To analyze short-term weight gain in obese children following intracapsular tonsillectomy.
- To compare weight changes between different classes of obesity post-surgery.
Main Methods:
- Retrospective cohort study of obese children (BMI >95th percentile) undergoing intracapsular tonsillectomy.
- Measurements of BMI as %BMIp95 recorded at least 30 and 90 days postoperatively.
- Children categorized into Class I (≤120 %BMIp95) and Class II/III (>120 %BMIp95) obesity.
Main Results:
- 68 obese children underwent the procedure, with 91% for obstructive breathing.
- No significant difference in %BMIp95 change was observed between Class I and Class II/III obesity at 6.9 months (1.77 vs 3.27, p=0.45).
- No significant differences in %BMIp95 change were found at >90 days post-surgery between obesity classes (1.17 vs 3.00, p=0.60).
Conclusions:
- Weight gain after intracapsular tonsillectomy was similar across different obesity classes in children.
- Consistent growth trajectories suggest intracapsular tonsillectomy is an appropriate technique for obstructive breathing in obese children.
- Further research can explore long-term outcomes and optimal surgical timing.
Objectives:
To analyze short-term weight gain among obese children after intracapsular tonsillectomy.
Methods:
A retrospective cohort included all children with a body mass index (BMI) > 95th percentile obtaining intracapsular tonsillectomy between 2021 and 2023 at a tertiary children's hospital. Measurements at least 30 days and at least 90 days postoperatively were recorded. BMI was expressed as a percentage of the 95th percentile (%BMIp95) and grouped by initial %BMIp95 ≤ 120 (class I obesity) or %BMIp95 > 120 (class II and III obesity).
Results:
There were 68 children that underwent intracapsular tonsillectomy at a mean age of 7.2 years (SD: 3.8) with obstructive breathing indications for 91% (N = 62). Mean %BMIp95 at surgery was 121 (95% confidence interval [CI]: 117-125). Class I obesity was noted for N = 39 (57%) and class II/III obesity was noted for N = 29 children (43%). At a mean of 6.9 months (SD: 5.3), the change in %BMIp95 was 1.77 (95% CI: -1.03 to 4.57) for class I and 3.27 (95% CI: 0.55 to 6.00) for class II/III obese children (p = 0.45). Measurements at least 90 days after surgery (mean: 12.8 months (SD: 5.2) showed no differences in %BMIp95 change between children with class I (1.17; 95% CI: -3.63 to 5.96) and class II/III obesity (3.00; 95% CI: -2.25 to 8.25) (p = 0.60).
Conclusion:
Weight gain after intracapsular tonsillectomy was similar between children with low and high obesity class. Consistent growth trajectories continued beyond 3 months, suggesting intracapsular tonsillectomy may be an appropriate technique to address obstructive breathing in obese children.
Level Of Evidence:
III.
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