Objective: Our study aimed to identify and describe pulmonary complications and its associated risk factors in children with suspected or confirmed obstructive sleep apnea (OSA) who underwent tonsillectomy or adenotonsillectomy in a tertiary government hospital. Methods: We conducted a retrospective cohort study. Medical charts of pediatric patients with suspected or confirmed OSA who were admitted for tonsillectomy or adenotonsillectomy from January 1, 2016 to December 31, 2020 were retrieved and reviewed. Information of the individual patients including the demographic data, clinical profile, polysomnography results, and presence of postoperative pulmonary complications were recorded. Descriptive statistics was utilized to present continuous data while frequency and percentage for categorical data. Fisher exact test was used to compare the demographic profile of patients with postoperative pulmonary complications from those without. Results: A total of 90 patient records were analyzed. The mean age of the patient population was 7.87 years, 55.6% were male, 17.8% of patients were classified as obese. Thirty-four children had preoperative polysomnography and of these, 47.1% were classified as severe. Only two (2.2%) patients had postoperative pulmonary complications, which were bronchospasm and desaturation, respectively. There were no statistically significant differences noted in comparing the clinicodemographic profile of patients with postoperative pulmonary complications from those without complications. Conclusion Our results showed that most pediatric patients with suspected or confirmed OSA who underwent adenotonsillectomy did not have pulmonary complications.
Sleep Apnea, Obstructive ; Tonsillectomy

OBJECTIVE

Our study aimed to identify and describe pulmonary complications and its associated risk factors in children with suspected or confirmed obstructive sleep apnea (OSA) who underwent tonsillectomy or adenotonsillectomy in a tertiary government hospital.

We conducted a retrospective cohort study. Medical charts of pediatric patients with suspected or confirmed OSA who were admitted for tonsillectomy or adenotonsillectomy from January 1, 2016 to December 31, 2020 were retrieved and reviewed. Information of the individual patients including the demographic data, clinical profile, polysomnography results, and presence of postoperative pulmonary complications were recorded. Descriptive statistics was utilized to present continuous data while frequency and percentage for categorical data. Fisher exact test was used to compare the demographic profile of patients with postoperative pulmonary complications from those without.

A total of 90 patient records were analyzed. The mean age of the patient population was 7.87 years, 55.6% were male, 17.8% of patients were classified as obese. Thirty-four children had preoperative polysomnography and of these, 47.1% were classified as severe. Only two (2.2%) patients had postoperative pulmonary complications, which were bronchospasm and desaturation, respectively. There were no statistically significant differences noted in comparing the clinicodemographic profile of patients with postoperative pulmonary complications from those without complications.

Our results showed that most pediatric patients with suspected or confirmed OSA who underwent adenotonsillectomy did not have pulmonary complications.

Objective:To investigate the changes of inflammation and immune function in children with chronic tonsillitis after tonsillotomy. Methods:Prospectively collected 60 children with obstructive sleep apnea （OSA） diagnosed as chronic tonsillitis with adenoids and tonsillar hypertrophy from January to June 2021. Two groups were divided, the experimental group （n=30） underwent bilateral partial tonsillectomy + adenoidectomy by hypothermia plasma ablation, and the control group （n=30） underwent adenoidectomy by using the same hypothermia plasma ablation method. The number of tonsillitis attacks before surgery and within one year after surgery was recorded, and the serum immunoglobulin IgM, IgG, IgA, complement C3 and complement C4 levels before operation, one month and three months after operation were measured. Results:The number of tonsillitis attacks in the experimental group and the control group at one year after surgery was lower than that before surgery（P<0.05）; The number of inflammatory attacks in the experimental group was （0.50±0.63） times/year, which was lower than that of （1.33±0.80） times/year in the control group. There was no significant difference in the five immunization results of the two groups at one month and three months after operation compared with before operation, and there was also no significant difference between the experimental and the control groups. Conclusion:Partial tonsillectomy can be applied to children with chronic tonsillitis, which can effectively reduce the number of tonsillitis attacks and has no effect on the immune function of children.
Child ; Humans ; Tonsillectomy/methods* ; Hypothermia ; Tonsillitis/surgery* ; Adenoidectomy ; Palatine Tonsil/surgery* ; Inflammation ; Chronic Disease ; Immunity

A 22-month-old male diagnosed with achondroplasia was referred for difficulty in sleeping and was diagnosed to have severe obstructive sleep apnea (OSA) on polysomnography (PSG) (AHI 50.1). This patient had macrocephaly, midface hypoplasia, flat nasal bridge, relative macroglossia and enlarged palatine and adenoid tonsils. The patient underwent bilateral tonsillectomy with adenoidectomy without complication. Six months post-op, repeat polysomnography revealed a still severe (AHI 15.7) OSA with preferential recovery of REM and N3 sleep. Further outpatient follow-up and management is warranted. OSA despite being common in this subset of patients remains overlooked and not prioritized because of the multitude of coexisting concerns. Management of OSA in children with achondroplasia shows improved sleep structure and is helpful for further growth and development.
achondroplasia ; OSA ; tonsillectomy

Humans ; Child ; Adenoids/surgery* ; Palatine Tonsil/surgery* ; Adenoidectomy ; Hypertrophy/surgery* ; Tonsillectomy

The authors report a case of post-tonsillectomy dysgeusia and discuss the pathogenesis, diagnostics, as well as treatment options done in several reported cases. A 37-year-old man who was diagnosed with recurrent tonsillitis underwent bilateral palatine tonsillectomy, and on the second post-operative day, post-tonsillectomy hemorrhage ensued which required emergency hemostasis at the operating room. Intra-operative findings include active bleeding on the left tongue base, wherein hemostasis was achieved via electrodissection. After the procedure, patient noted a disturbance to taste that persisted for several months. Dysgeusia is an unusual complication of tonsillectomy, occurring in 0.3% to 9% of cases.
Tonsillectomy ; dysgeusia

Objective: To study voice changes in children after adenotonsillectomy or adenoidectomy and the relationship with the vocal tract structure. Methods: Fifty patients were recruited in this study prospectively, aged from 4 to 12 years old with the median age of 6. They were underwent adenotonsillectomy or adenoidectomy in Beijing Tongren Hospital, Capital Medical University from July 2019 to August 2020. In the cases, there are 31 males and 19 females. Thirty-six patients underwent adenotonsillectomy and 14 patients underwent adenoidectomy alone. Twenty-two children (13 males, 9 females) with Ⅰ degree of bilateral tonsils without adenoid hypertrophy and no snoring were selected as normal controls. Adenoid and tonsil sizes were evaluated. Subjective changes of voice were recorded after surgery. Moreover, voice data including fundamental frequency(F0), jitter, shimmer, noise to harmonic ratio(NHR), maximum phonation time(MPT), formant frequencies(F1-F5) and bandwidths(B1-B5) of vowel/a/and/i/were analyzed before, 3 days and 1 month after surgery respectively.SPSS 23.0 was used for statistical analysis. Results: Thirty-six patients(72.0%,36/50) complained of postoperative voice changes. The incidence was inversely correlated with age. In children aged 4-6, 7-9, and 10-12, the incidence was 83.3%(25/30), 63.6%(7/11) and 44.4%(4/9) respectively. Voice changes appeared more common in children underwent adenotonsillectomy(77.8%,28/36) than in those underwent adenoidectomy alone(57.1%,8/14), but there was no statistical difference. After operation, for vowel/a/, MPT(Z=2.18,P=0.041) and F2(t=2.13,P=0.040) increased, B2(Z=2.04,P=0.041) and B4(Z=2.00,P=0.046) decreased. For vowel/i/, F2(t=2.035,P=0.050) and F4(t=4.44,P=0.0001) increased, B2(Z=2.36,P=0.019) decreased. Other acoustic parameters were not significantly different from those before surgery. The F2(r=-0.392, P =0.032) of vowel/a/and F2(r=-0.279, P=0.048) and F4 (r=-0.401, P =0.028) of vowel/i/after adenotonsillectomy were significantly higher than those of adenoidectomy alone. Half of patients with postopertive voice changes can recover spontaneously 1 month after surgery. Conclusions: Voice changes in children underwent adenotonsillectomy or adenoidectomy might be related to their changes in formants and bandwidths. The effect of adenotonsillectomy on voice was more significant compared with that of adenoidectomy alone. The acoustic parameters did not change significantly after surgery except MPT.
Adenoidectomy ; Adenoids/surgery* ; Child ; Child, Preschool ; Female ; Humans ; Male ; Speech Acoustics ; Tonsillectomy ; Voice Quality

Adenoidectomy ; Adenoids ; Humans ; Hypertrophy ; Microbiota ; Palatine Tonsil ; Tonsillectomy

Acquired Hyperostosis Syndrome/surgery* ; Humans ; Tonsillectomy

Child ; Consensus ; Humans ; Hypopharynx ; Tonsillectomy ; Tonsillitis