Our Summary

This study looked at how often serious breathing problems happened after young children had surgery to remove their adenoids, and what factors might mean they needed to stay in the hospital afterwards.

The researchers checked the records of children aged 3.5 years or younger who had this surgery because they were having trouble breathing. The children were divided into three age groups. They didn’t include children who were having the surgery for a second time, were also having their tonsils taken out, or were having another major surgery.

They found that 353 patients fit their criteria. The only differences between the age groups were their age, body mass index, and the proportion of Black or African American children. The youngest children (under 1.5 years) were more likely to have had a sleep study before surgery, showing lower oxygen levels, and were more likely to have the surgery because of sleep apnea.

There were no differences between the age groups in problems in the recovery room, calls from nurses, or being re-admitted to hospital within 30 days of surgery. About 35% of all the children were kept in hospital after surgery, and this was more likely for the youngest children.

About 17% of all the children had problems after surgery needing special treatment or a longer stay in hospital, and this was the same across all age groups. However, these problems were more common in younger children, those with more health problems, and those with serious results on their pre-surgery sleep studies.

The study concludes that serious breathing problems after adenoid surgery are uncommon, even in very young children. However, children under 1.5 years old or those with more than 5 apnea events per hour should be kept in hospital for monitoring after surgery. Doctors should use their judgement when deciding if older children or those with other health problems can have the surgery as outpatients.

FAQs

  1. What factors were studied to determine the potential need for a hospital stay after adenoidectomy in young children?
  2. What were the common issues found in children after undergoing adenoidectomy?
  3. What is the study’s conclusion regarding the frequency of serious breathing problems post-adenoidectomy in young children?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adenoidectomy is to closely monitor their child’s breathing after the surgery, especially if they are under 1.5 years old or have a history of sleep apnea. It may be necessary for these children to stay in the hospital for monitoring to ensure their safety and well-being. Additionally, parents should follow any post-operative care instructions provided by their healthcare provider to help ensure a smooth recovery.

Suitable For

Patients who are typically recommended for adenoidectomy include young children (under 3.5 years old) who are experiencing serious breathing problems, especially those with sleep apnea or low oxygen levels. Young children under 1.5 years old or those with more than 5 apnea events per hour may be recommended to stay in the hospital for monitoring after surgery. Additionally, patients with more health problems or serious results on pre-surgery sleep studies may also be recommended for adenoidectomy. Ultimately, doctors should use their judgement when determining if a patient is a suitable candidate for adenoid surgery as an outpatient procedure.

Timeline

Before adenoidectomy:

  • Patient experiences breathing difficulties, such as snoring, sleep apnea, or recurrent ear infections.
  • Patient may undergo a sleep study to assess their breathing during sleep.
  • Patient is scheduled for adenoidectomy surgery to remove enlarged adenoids.

After adenoidectomy:

  • Patient undergoes surgery to remove adenoids.
  • Patient may experience symptoms such as sore throat, ear pain, or nasal congestion after surgery.
  • Patient is monitored in the recovery room for any immediate complications.
  • Patient may be kept in the hospital for monitoring, especially if they are under 1.5 years old or have more severe breathing problems.
  • Patient may experience complications after surgery, such as bleeding or infection, which may require additional treatment or a longer hospital stay.
  • Patient may have a follow-up appointment to monitor their recovery and address any ongoing symptoms or concerns.

What to Ask Your Doctor

  1. What factors determine whether my child needs to stay in the hospital after adenoidectomy surgery?
  2. What are the potential risks and complications associated with adenoidectomy in young children?
  3. How common are serious breathing problems after adenoid surgery in children under 3.5 years old?
  4. Are there any specific age groups or health conditions that may increase the likelihood of complications after adenoidectomy?
  5. What signs and symptoms should I watch for at home following my child’s adenoidectomy surgery?
  6. How soon after surgery should I contact you if my child experiences any concerning symptoms?
  7. Will my child need a follow-up appointment after their adenoidectomy surgery?
  8. Are there any specific precautions or restrictions my child should follow during their recovery period?
  9. How long is the typical recovery time for young children after adenoidectomy surgery?
  10. Are there any specific guidelines or recommendations for caring for my child at home after adenoidectomy surgery?

Reference

Authors: Chorney SR, Dailey JF, Zur KB. Journal: Int J Pediatr Otorhinolaryngol. 2020 Mar;130:109796. doi: 10.1016/j.ijporl.2019.109796. Epub 2019 Nov 25. PMID: 31794902