Journal Reviews
Adenotonsillectomy day-case discharge criteria: a systematic review
In this paper, Gowda et al review the literature aiming to answer a long-standing question regarding the criteria for same-day discharge of paediatric patients post adenoidectomy and/or tonsillectomy performed for treatment of obstructive sleep apnoea (OSA). Following PRISMA consensus, they...
The incidence of coagulopathies in children presenting with post-tonsillectomy haemorrhage
Tonsillectomy is often the first haemostatic challenge for a child. Postoperative haemorrhage may therefore represent the first presentation of a child’s underlying bleeding disorder. This study aimed to quantify the rate of occult coagulopathy in patients who had experienced a...
Do parents sleep better after paediatric adenotonsillectomy?
Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...
Is surgery in obese children with obstructive sleep apnoea effective?
The authors present the results of their literature review and meta-analysis of studies examining adenotonsillectomy, uvulopalatopharyngoplasty (UPPP), supraglottoplasty, tongue base surgery or a combination in obese children with obstructive sleep apnoea (OSA). The one study investigating effects of UPPP was...
The effect of adenotonsillectomy on the immune system
Parents often ask about the effect of adenotonsillectomy on the immune system, with concerns that the child may be prone to more infections postoperatively due to the absence of immune tissue. This Belgian literature review looked at the local and...
Factors determining success of adenotonsillectomy in paediatric obstructive sleep apnoea
Patient selection is important for any successful surgical procedure. Adenotonsillectomy for obstructive sleep apnoea secondary to adenotonsillar hypertrophy is no exception. This retrospective Taiwanese study attempts to find preoperative factors that have a positive influence for this commonly performed operation....
Surgical options for children with OSA
This paper looks at the surgical management of OSA in children and approaches the method of patient selection initially. They discuss the role of polysomnography in that it is part of the AAOHNS criteria in those patients with OSA symptoms...
Velopharyngeal insufficiency after adenotonsillectomy
The authors retrospectively reviewed the clinical records of 320 paediatric patients who underwent either tonsillectomy, adenoidectomy or adenotonsillectomy, under a single paediatric ENT surgeon. Patients with pre-existing velopharyngeal insufficiency (VPI) were excluded, as assessed by preoperative testing for nasal air...
Long-term outcomes after (adeno) tonsillectomy
Patient-reported outcome measures (PROMs) are used increasingly to fill an ‘evidence gap’ where healthcare rationing threatens particular treatments. Tonsillectomy is a long-established and effective treatment for recurrent tonsillitis and obstructive sleep apnoea (OSA) in children. The T-14 outcome measure examines...
Local dexamethasone infiltration in tonsillectomy
Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...
What’s the risk of regrowth with partial (intracapsular) tonsillectomy
Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre...
