Can children younger than three go home the same day after a less invasive tonsil operation?

Details

The study assessed the safety and efficacy of outpatient intracapsular tonsillectomy in children younger than 3 years. This operation had recently been described as a less invasive treatment for obstructive tonsillar hypertrophy. The researchers also sought to challenge the standard recommendation that children younger than 3 years be admitted to hospital after tonsil and adenoid surgery.

This was a retrospective cohort study using medical chart review and telephone interview, conducted in a pediatric otolaryngology group practice with academic affiliation. It included 226 children with symptomatic tonsillar and adenoid hypertrophy who underwent microdebrider-assisted intracapsular tonsillectomy between September 1, 2000, and October 1, 2002.

The researchers compared 38 children younger than 3 years with 188 children aged 3 years or older. The younger group had a mean age of 30.3 months and included 20 boys and 18 girls. Outcomes measured were pain, oral intake, analgesic requirements, complications, need for readmission, and relief of symptoms.

There were no statistically significant differences between the groups in pain, oral intake, or analgesic requirements. All children, regardless of age, were discharged home within 4 hours of surgery. No child in either group required readmission, and there were no complications related to the time of discharge. Younger children experienced equivalent symptomatic improvement.

The authors concluded that children younger than 3 years may undergo intracapsular tonsillectomy as outpatients without sacrificing safety or efficacy.