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Pediatric Otolaryngology

(516) Trisomy 21 and Outcomes of Tonsillectomy

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

    Presenting Author(s)

  • Camron M. Davies, MD

    Resident Physician
    Loma Linda University Health
    Riverside, California, United States

    • Co-Author(s)

  • Joseph M. Berry, B.S.

    Clinical Research Fellow; M4 Medical Student
    University of Tennessee Health and Science Center; University of Mississippi Medical Center
    Jackson, Mississippi, United States

  • Dhruv S. Kothari, MD

    Otolaryngology Resident
    Cedars-Sinai Medical Center
    Los Angeles, California, United States

    • Senior Author(s)

  • Sanjeet V. Rangarajan, MD, MEng

    Associate Professor of Otolaryngology - Head and Neck Surgery
    University of Tennessee Health Science Center
    Memphis, Tennessee, United States

  • RY

    Robert J. Yawn, MD, MBA

    University of Tennessee Health Science Center, USA

  • Anthony M. Sheyn, MD, FACS

    Division Chief, Pediatric Otolaryngology
    LeBonheur Children's Hospital
    Memphis, Tennessee, United States

Disclosure(s):
Camron M. Davies, MD: No relevant relationships to disclose.
Joseph M. Berry, B.S.: No relevant relationships to disclose.
Dhruv S. Kothari, MD: No relevant relationships to disclose.
Sanjeet V. Rangarajan, MD, MEng: No relevant relationships to disclose.
Anthony M. Sheyn, MD, FACS: No relevant relationships to disclose.


Introduction: Tonsillectomy is a common procedure performed within the Trisomy 21 (Down Syndrome) population for Obstructive Sleep Apnea (OSA) or recurrent tonsilitis. Traditionally, this procedure presents with some but limited complications; however, we set out to determine if this remains true within the Down Syndrome population or if they are at increased risk compared to those without Down Syndrome.

Methods: A retrospective analysis using TriNetX datasets from 2014 to present compared the outcomes of two cohorts: Cohort 1 (110) named Tonsillectomy with Trisomy 21 ≤ 18 years old and Cohort 2 (7,390) named Tonsillectomy without Trisomy 21 ≤ 18 years old. The following outcomes were measured: fever (T 101.00 F), elevated WBCs (12.00 10*13/uL), need for antibiotics, need for opioids, surgical complications, ER visit, and dehydration.

Results: Results presented as risk ratio with 95% confidence interval (RR [95%CI]). We found that individuals within Cohort 1 were at increased risk for Fever (9.8% v 0.8%; [RR]: 11.197, [5.890, 21.287]), Elevated WBC (9.1% v 2.0%; [RR]: 4.479, [2.429, 8.258]), a prescription of antibiotics (36.4% v 19.5%; [RR]: 1.866, [1.451, 2.400]), need for opioids (27.3% v 14.1%; [RR]: 1.938, [1.421, 2.643]), surgical complications (9.1% v 3.4%; [RR]: 2.687, [1.470, 4.913]), and dehydration (9.1% v 2.4%; [RR]: 3.732, [2.031, 6.858]). There was no significant difference in return to the ER between the two groups.

Conclusions: We found that individuals with Downs Syndrome were at increased risk with 6 out of the 7 outcomes that were observed post-tonsillectomy. This allows us to conclude that Down Syndrome is a significant risk factor when performing tonsillectomy. Further research can include a prospective study in which you look at ways of decreasing the negative outcomes mentioned, including overnight hospitalization.