Characteristics Associated With Need for Upper Airway Surgery After Tonsillectomy

Sunday, October 1, 2023

1:42 PM - 1:48 PM East Coast USA Time

Location: 207CD

Presenting Author(s)

Abby R. Buckley, Other

Medical Student
1. Nationwide Children's Hospital Department of Otolaryngology 2. The Ohio State University College of Medicine
Columbus, OH, United States

Co-Author(s)

Michael J. Boutros, BS

Medical Student
1. Nationwide Children's Hospital Department of Otolaryngology 2. University of Miami Miller School of Medicine
Sylvania, OH, United States
CC

Coreena K. Chan, BS

Medical Student
The Ohio State University College of Medicine
Columbus, OH, United States
Megan E. McNutt, B.S.

Clinical Research Associate
1. Nationwide Children's Hospital Department of Otolaryngology
Columbus, OH, United States
TB

Tran Bourgeois, MPH

Center for Surgical Outcomes Research, The Research Institute at Nationwide Children’s Hospital
Columbus, Ohio, United States

Senior Author(s)

ML

Meredith N. Lind, MD

Associate Professor of Otolaryngology
1. Nationwide Children's Hospital Department of Otolaryngology 2. The Ohio State University College of Medicine
Columbus, OH, United States

Disclosure(s):

Abby R. Buckley, Other: No relevant relationships to disclose.

Michael J. Boutros, BS: No relevant relationships to disclose.

Meredith N. Lind, MD: No relevant relationships to disclose.

Introduction: In children undergoing tonsillectomy (T) or adenotonsillectomy (AT), surgeons should consider other needed upper airway surgeries (UAS) to minimize the need for future surgery. This study seeks to estimate the incidence and types of UAS performed after T or AT, and identify factors associated with the need for UAS.

Methods: Institutional review board approval was obtained for a retrospective cohort study on patients aged 0 to 18 years who received either a T or AT in 2015 at a single tertiary care center. Charts were reviewed to determine incidence of UAS in the next three years. Patient demographics, surgical findings, methods, indications, and comorbidities at the initial encounter were recorded. Subsequent UAS encounters included: nasal procedures, turbinate reduction, direct laryngoscopy and bronchoscopy (DLB), secondary adenoidectomy, sinus surgery, pharyngeal surgery, sleep endoscopy, supraglottoplasty, and frenotomy.

Results: Among 2133 patients, median age at index surgery was 5.9 years (IQR: 3.95, 8.54) and 67% (n = 1316) were females. Incidence of UAS was 2.95% (n = 63). The most common UAS were nasal procedures (40% [n = 25 / 63]), turbinate reduction (35% [n = 22/63]), and DLB (27% [n = 17/63]). With increasing age, children were less likely to need UAS (OR: 0.89 95% CI [0.82 – 0.97] P = 0.0087). Older children (OR: 0.65 95% CI [0.45 – 0.96] P = 0.0293) and those who weighed more (OR: 0.86 95% CI [0.75 – 0.99] P = 0.0413) were less likely to need secondary adenoidectomy. Need for UAS was not found to be associated with any other cohort characteristics (P > 0.05).

Conclusions: Younger age at time of index surgery is associated with UAS and secondary adenoidectomy. Additional factors associated with the need for UAS were not identified.