Revisiting outpatient tonsillectomy in young children.
OBJECTIVE
Postoperative same-day discharge is safe for most children undergoing tonsillectomy. However, young children with upper airway obstruction have a higher risk of postoperative complications. We review our tonsillectomy experience in children under 36 months to evaluate the safety of outpatient tonsillectomy in this population.


METHODS
We conducted a retrospective study of all children under 36 months who underwent tonsillectomy during a recent 2-year period at The Children's Hospital of Philadelphia.


RESULTS
The indication for tonsillectomy in 96% of 421 children was upper airway obstruction. Eighteen percent required postoperative treatment to prevent respiratory compromise; 56% of these patients had no associated medical comorbidity. Patients younger than 24 months and those with medical comorbidities were more likely to require intervention.


CONCLUSIONS
It is not possible to preoperatively anticipate which children will have postsurgical complications. We recommend planning an overnight admission for children younger than 36 months undergoing tonsillectomy.
Ross
Adam T
AT
Department of Otorhinolaryngology-Head and Neck Surgery, The University of Pennsylvania School of Medicine and The Children's Hospital of Philadelphia, 19104, USA.
Kazahaya
Ken
K
Tom
Lawrence W C
LW
D000402:Airway Obstruction / Q000601:surgery; D000556:Ambulatory Surgical Procedures; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods