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Safety of Adenotonsillectomy in Children with Genetic Syndromes

Comert Sen1, Ömer Orak1, Tülay Günsay1

  • 1Department of Otorhinolaryngology - Head and Neck Surgery, Istanbul Faculty of Medicine, Istanbul University, Türkiye.

Ear, Nose, & Throat Journal
|November 1, 2025
PubMed

Insights

Adenotonsillectomy (AT) is safe for children with genetic syndromes, including Down syndrome (DS). This procedure shows low complication rates, making it a viable option for these high-risk patients.

Area of Science:

  • Pediatric Otolaryngology
  • Genetics
  • Surgical Safety

Background:

  • Children with genetic syndromes, particularly Down syndrome (DS), are considered high-risk for adenotonsillectomy (AT) due to unique anatomical and comorbidity profiles.
  • Evaluating the safety of AT in this population is crucial for informed clinical decision-making.

Purpose of the Study:

  • To assess the safety and complication rates of adenotonsillectomy (AT) in pediatric patients with Down syndrome (DS) and other genetic syndromes (OS).

Main Methods:

  • Retrospective review of 62 pediatric patients (<18 years) with genetic syndromes (46 DS, 16 OS) who underwent AT or tonsillectomy with or without ventilation tube insertion between 2010-2025.
  • Data collected included demographics, comorbidities, surgical details, complications, and hospital stay duration.

Main Results:

  • The primary indications for surgery were sleep-disordered breathing (82.3%) and recurrent tonsillitis (25.8%).
  • The overall complication rate was low at 8.1%, with no emergency admissions or perioperative mortality. Specific complications included bleeding (1.6%), respiratory events (1.6%), and poor oral intake (4.8%).
  • Most patients (93.5%) were discharged within 1 day, though 2 OS patients required planned ICU admission.

Conclusions:

  • Adenotonsillectomy (AT) is a safe surgical procedure for children with genetic syndromes, including Down syndrome (DS).
  • The study demonstrates low complication rates and short hospital stays, supporting the use of AT in this patient group.
Abstract

Keywords:
Down syndromeadenotonsillectomycongenital anomaliesgenetic syndromepostoperative complicationstonsillectomy

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