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Pediatric Otolaryngology

(371) Pediatric Lingual Tonsillectomy: Is Inpatient Observation Required?

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • Kylie Smith, DO

    Resident
    Ascension Macomb-Oakland
    Warren, Michigan, United States

    • Co-Author(s)

  • Robert M. Conway, DO

    Fellow
    Michigan Ear Institute
    Farmington Hills, Michigan, United States

  • Natalie Wall, DO

    Resident
    Ascension Macomb-Oakland Hospital
    Madison Heights, Michigan, United States

    • Senior Author(s)

  • PT

    Prasad J. Thottam, DO

    Director of Pediatric Aerodigestive Disorders
    Beaumont Children's Hospital Pediatric Aerodigestive Center
    West Bloomfield, Michigan, United States

Disclosure(s):
Kylie Smith, DO: No relevant relationships to disclose.
Robert M. Conway, DO: No relevant relationships to disclose.
Natalie Wall, DO: No relevant relationships to disclose.
Prasad J. Thottam, DO: No relevant relationships to disclose.


Introduction: The purpose of this study was to analyze factors associated with lingual tonsillectomy postoperative complications and determine which patients may require overnight hospitalization.

Methods: Retrospective study analyzing 65 pediatric patients undergoing lingual tonsillectomy by Pediatric Otolaryngologists. Inclusion criteria included pediatric patients who underwent lingual tonsillectomy for treatment of obstructive sleep apnea (OSA) with subsequent drug induced sleep endoscopy (DISE) verifying the lingual tonsils as the site of obstruction. Supplemental oxygen, pain control, complications, and readmission rates were the primary factors evaluated.

Results: Sixty-five patients were included in the study. No significant complications were identified during hospital admission and observation period. No patients required supplemental oxygen outside of the initial post-anesthesia care unit (PACU) period. Twenty-two patients required at least one dose of opiate pain medication during admission with no statistical significance on postoperative complications or readmission rates. All patients were discharged on post-operative day 1 (POD1). Eight patients (12.3%) had one or more postoperative complications with the earliest at POD3 and 3 patients (4.6%) required readmission with the earliest at POD8. There were no significant differences of patients with comorbidities or concurrent surgical operations and postoperative complications. Patients with concurrent epiglottopexy and lingual tonsillectomy had a higher readmission rate (p=0.048).

Conclusions: This study demonstrated that pediatric patients undergoing lingual tonsillectomy for OSA had no immediate or 24-hour postoperative complications that inpatient admission would better help control. No patients required inpatient attention for pain control, respiratory distress or hemorrhaging. This study suggests that pediatric patients undergoing lingual tonsillectomy may be able to be addressed in an outpatient setting and not require overnight admission.