Complications of adenotonsillectomy.
OBJECTIVE
Tonsillectomy and adenoidectomy are two of the most commonly performed pediatric surgical procedures. As with all surgical intervention, tonsillectomy and adenoidectomy are associated with a host of potential complications. Fortunately, for most children undergoing adenotonsillectomy (T&A), complications are rare. This review is intended to summarize recent reports, which may lead to prevention and treatment of T&A complications.


RESULTS
The presented reports of complications and risk factors for complications in children undergoing T&A highlight perioperative medical management as a means to decrease perioperative complications. Certain tonsillectomy techniques, such as microdebrider intracapsular tonsillectomy, may lead to decreased posttonsillectomy hemorrhage and dehydration. Despite published recommendations, preoperative assessments for bleeding diatheses vary among practitioners. Conversely, guidelines for evaluation of posttonsillectomy hemorrhage are lacking. Some pediatric populations, such as children with coagulopathy, neurologic disease, and obesity, have increased risk of perioperative complications, and recent reports regarding their care are presented.


CONCLUSIONS
We present recent data pertinent to the contemporary management of medical and surgical complications of T&A, with particular focus on specific at-risk pediatric populations. In the patient groups illustrated in this review, anticipation of complications may decrease complications or lead to improved management of complications when they occur.
Department of Otolaryngology, University of Cincinnati, and Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
Melissa M
MM
Statham
Charles M
CM
Myer
D000233:Adenoidectomy / Q000009:adverse effects* / Q000379:methods; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy* / Q000503:physiopathology; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
D000700:Analgesics