Toward Adenotonsillectomy in Children

Ingram, David G.; Friedman, Norman R.

doi:10.1001/jamapediatrics.2015.2016

Cited by 50 publications

(22 citation statements)

References 79 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Tonsillectomy is one of the most commonly performed otolaryngologic operations in the United States, with over half a million outpatient procedures performed annually for sleep‐disordered breathing or recurrent throat infections . Although randomized clinical trials have demonstrated the effectiveness of tonsillectomy, postoperative hemorrhage is a serious complication with potentially devastating consequences, including mortality …”

Section: Introductionmentioning

confidence: 99%

Frequency of post‐tonsillectomy hemorrhage relative to time of day

et al. 2019

View full text Add to dashboard Cite

Objectives Postoperative hemorrhage is a serious complication of tonsillectomy, with secondary bleeding rates affecting up to 0.8% to 3% of patients. Although these bleeds are anecdotally perceived as occurring more frequently at night, the occurrence of hemorrhage relative to the time of day has not been investigated. We measured the frequency of post‐tonsillectomy hemorrhage onset relative to the time of day. Methods We reviewed electronic medical records of all patients who experienced postprocedural hemorrhage (International Classification of Disease, Ninth Edition [ICD‐9] 998.11, ICD‐10 J95.830 at two hospitals within a tertiary academic health system in a 10‐year period). Patient demographics, time of bleed onset, emergency room [ED] arrival time, and management (operating room vs. observation) were abstracted. Patients without a recorded bleeding time were excluded. Time of bleed onset was categorized as morning (6:01 am–12 pm), afternoon (12:01 pm–6 pm), evening (6:01 pm–12 am), or overnight (12:01 am–6 am). Chi‐square goodness of fit test was used to assess the distribution of hemorrhage timing (P ≤ 0.05). Results A total of 7,396 patients underwent tonsillectomy May 2008 through May 2018, among whom 121 (2%) post‐tonsillectomy hemorrhage patients were identified. Among the 104 patients with ED arrival times, 29 (28%) arrived in the morning; 15 (14%) arrived in the afternoon; 40 (38%) arrived in the evening; and 20 (19%) arrived overnight (P = 0.003). Sixty patients (mean age 17.1 years, standard deviation 16.6) had a recorded timing of bleed onset. Bleed onset occurred most commonly overnight (24, 40%), followed by evening (21, 35%), afternoon (11, 18%), and morning (4, 7%) (P = 0.0007). Conclusion In this cohort, post‐tonsillectomy hemorrhage occurred most frequently between midnight and 6 am. Our findings confirm anecdotal experience and provide data in setting caregiver expectations. Level of Evidence 4 Laryngoscope, 130:1823–1827, 2020

show abstract

Section: Introductionmentioning

confidence: 99%

Frequency of post‐tonsillectomy hemorrhage relative to time of day

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Adenoidectomy is a common pediatric surgical procedure performed by otolaryngologists today [1]. The surgical indications for adenoidectomy as stated on the website of the American Academy of Otolaryngology/Head and Neck surgery as of 2017 include [2]:…”

Section: Introductionmentioning

confidence: 99%

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Schüpper

Nation

Pransky

2018

Curr Otorhinolaryngol Rep

View full text Add to dashboard Cite

Purpose of Review Review the current state of the adenoidectomy procedure in the pediatric population with up-to-date indications for surgery, operative techniques, adverse events, non-surgical management of adenoid hypertrophy, and future directions. Recent Findings Adenoidectomy is indicated in children for the treatment of sleep-disordered breathing, nasal airway obstruction, recurrent acute otitis media, and chronic rhinosinusitis. A new recommendation was released in 2016, not supporting adenoidectomy for a primary indication of otitis media in children under 4 years old, including those with prior tympanostomy tubes, unless a distinct indication exists such as nasal obstruction or chronic adenoiditis. Although adenotonsillectomy is the mainstay of treatment for obstructive sleep apnea (OSA), recent studies have identified that non-obese patients with moderate OSA and small tonsils have comparable benefits with adenoidectomy alone with less complications. While conventional approaches such as indirect mirror-assisted curette and suction coagulation are still utilized, direct transnasal endoscopeassisted removal of the adenoids has proven to be a safe technique, with good short-and long-term outcomes. Novel nonsurgical therapies including immunotherapy have been evaluated. Summary Adenoidectomy is a safe procedure in the pediatric population and leads to excellent outcomes. Adverse events are rare, and hospitalization is uncommon. Children with sleep disturbance from nasal airway obstruction, ear disease, or chronic rhinosinusitis are the best operative candidates for this procedure.

show abstract

“…Key words: Adenotonsillar, hypertrophy, hyperplasia, adenotonsillectomy, overweight, obesity inTroDuCCión La adenoamigdalectomía (AA) corresponde a una de las cirugías otorrinolaringológicas más frecuentemente realizadas, especialmente en población pediátrica donde se reportan cerca de 530.000 procedimientos anuales en USA 1 . Tradicionalmente, la amigdalitis recurrente corres pondía a la indicación más frecuente de AA.…”

Section: Conclusion: the Adenotonsillectomy By Symptomatic Adenotonsiunclassified

Influencia del exceso de peso en el éxito de la adenoamigdalectomía en pacientes con hiperplasia adenoamigdalina sintomática

et al. 2018

Rev. Otorrinolaringol. Cir. Cabeza Cuello

View full text Add to dashboard Cite

show abstract

Toward Adenotonsillectomy in Children

Cited by 50 publications

References 79 publications

Frequency of post‐tonsillectomy hemorrhage relative to time of day

Frequency of post‐tonsillectomy hemorrhage relative to time of day

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Influencia del exceso de peso en el éxito de la adenoamigdalectomía en pacientes con hiperplasia adenoamigdalina sintomática

Contact Info

Product

Resources

About