Tonsil and adenoid surgery for airway obstruction: perioperative respiratory morbidity.
A series of 160 consecutive patients undergoing tonsil and adenoid surgery for upper airway obstruction is reported. The ages ranged from 8 months to 13 years. Sixty-seven percent were 2, 3, or 4 years of age. All were routinely admitted overnight postoperatively. Forty-five (28%) remained in the hospital longer than one night (2 to 20 days). Postoperative respiratory problems were the reason for prolonged hospital stay in 30 of these 45 patients. Preoperative "danger-signals" of potential postoperative respiratory problems were: a history of severe obstructive symptoms with apnea and moderate or strongly positive sleep study, daytime somnolence, need for urgent T&A, and cardiomegaly. Risk factors present in a smaller number of patients were obesity, congenital stenosis of airways, and bronchopulmonary dysplasia. We suggest that children with these danger signals not be considered as candidates for outpatient T&A surgery.
Price
S D
SD
Department of Otolaryngology-Head and Neck Surgery, Los Angeles County+University of Southern California Medical Center 90033.
Hawkins
D B
DB
Kahlstrom
E J
EJ
D000233:Adenoidectomy; D000234:Adenoids / Q000601:surgery*; D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D000556:Ambulatory Surgical Procedures; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D014066:Palatine Tonsil / Q000601:surgery*; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis; D014068:Tonsillectomy