title: Is it safe to perform adenotonsillectomy in children with Down syndrome?
abstract: This retrospective review aims to evaluate the postoperative morbidity and mortality of 30 patients with Down syndrome who underwent adenotonsillectomy between June 2012 and December 2015 in a tertiary referral center. Mean age was 7.8 with a range of 3-12. There were 20 (66.6 %) male and ten (33.3 %) female patients. Mean follow-up was 23 months with a range of 7-43 months. 23 (76.6 %) of 30 patients had been operated due to obstructive tonsillar and adenoid hypertrophy, whereas seven (23.3 %) of them operated for chronic recurrent infections. All of the patients had undergone adenotonsillectomy operation; one patient had also bilateral tympanostomy tube insertion. Hospital stay was noted 1.3 days in average with a range of 1-3 days. Anesthetic complications of persistent bradycardia and postextubation respiratory difficulty occurred in two (6.6) patients. Patient who had intraoperative bradycardia necessitated intensive care unit stay and pacemaker implantation during follow-up. 3 (10 %) patients had late onset hemorrhage between days 7 and 10 and required intraoperative bleeding control. We did not experience any other morbidity and mortality except the abovementioned ones. In conclusion, adenotonsillectomy in patients with Down syndrome is a worthwhile operation with certain risks and these operations should better be performed by the tertiary referral centers which have the capacity to deal with the complications.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey. dralicemal@yahoo.com.|Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA. dralicemal@yahoo.com.
authors.forename: Ali Cemal
authors.initials: AC
authors.lastname: Yumusakhuylu
authors.affiliation: Ministry of Health Marmara University Education and Research Hospital ENT Clinic, Istanbul, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Binnetoglu
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Berat
authors.initials: B
authors.lastname: Demir
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Tekin
authors.initials: T
authors.lastname: Baglam
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sari
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000601:surgery; D015996:Survival Rate / Q000639:trends; D014068:Tonsillectomy / Q000379:methods*; D014069:Tonsillitis / Q000150:complications / Q000601:surgery*; D014421:Turkey / Q000453:epidemiology
keywords: Adenoidectomy; Bradycardia; Complication; Down syndrome; Obstructive sleep apnea; Tonsillectomy