(387) Postoperative Complications in Lingual Versus Palatine Tonsillectomy

Introduction: Risks of lingual tonsillectomy (LT) have not been described in a large cohort. Our objective was to compare these risks to those of palatine tonsillectomy (PT).

Methods: A retrospective cohort study was conducted using data from the US collaborative network within TriNetX, a global EHR database. The LT group was defined using CPT code 42870 and PT group using CPT codes 42820, 42821, 42825, or 42826. Groups were further subdivided into pediatric and adult populations. Post-operative bleeding, dehydration, dysphagia, ER visits, ICU care, and subsequent hospital care occurring within 14 days of procedure were compared between the groups within adult and pediatric populations.

Results: Propensity score matching was conducted for age, yielding a mean age of 43 years for the adult population (N=1357) and 8 for the pediatric population (N=848). Compared to the adult PT group, dysphagia occurred 2.77x more frequently (p <.0001), initiation of ICU care occurred 3.87x more frequently (p <.0001), and subsequent hospital care occurred 2.77x more frequently (p <.0001) in the LT group. In the pediatric group, subsequent hospital care occurred 6.25x more frequently (p <.0001) and dysphagia occurred 2.4x more frequently (p=.02) in the LT group than in the PT group. However, in the pediatric PT group postoperative bleeding occurred 2.67x more frequently than in the pediatric LT group, occurring in 3.77% of PTs and 1.41% of LTs (p=.004). There was no statistical difference in bleeding between adult PT and LT groups, occurring at a rate 3.83% and 4.42% respectively (p=.50).

Conclusions: Post-operative complications after lingual tonsillectomy are more common than after palatine tonsillectomy in both adults and children.