All Title Author
Keywords Abstract

Pattern of Paediatric Adenoid and Tonsillar Surgery in Ekiti

DOI: 10.4236/ijcm.2018.912070, PP. 841-853

Keywords: Adenotonsillectomy, Adenoidectomy, Tonsillectomy, Indication, Techniques, Complications

Full-Text   Cite this paper   Add to My Lib


Background: Surgeries of adenoid, tonsils or both are common pediatric performed by otorhinolaryngologist, head, and neck surgeon worldwide. Clinical pattern and management varied in a different center. This study aimed at determining the rate, socio-demographic features, indications, barriers, types, complications and patients’ satisfaction with adenoid and tonsils surgery in low-income countries. Materials and Methods: This is a hospital-based retrospective study of pediatric patients who had adenotonsillectomy, adenoidectomy, and tonsillectomy in the study center. This study was carried out over a period of ten years from March 2007 to February 2017. Data for this study was obtained from the medical record department, ENT clinic operation booking register and theatre operation register. All the data obtained were statistically analyzed using SPSS version 16. The data were then expressed by descriptive statistics table, bar charts, and pie charts. Ethical clearance was sought for and obtained from the ethical committee of the institution. Results: A total of 463 patients were booked for adenoid and tonsillar surgery out of which 214 patients had surgery done during the study period. This represented 46.2% of the participants that had surgery done. Adenotonsillectomy peaked 38.3% at preschool age group: (1 - 5) years. There were 58.9% males and male to female ratio was 1.5:1. Majority 42.5% of the patients reside in the city while minority 25.7% of the patients were village dwellers. Preschool ages were the majority 40.2% while post-secondary schools ages were the minority 8.4% of the patients. The parents of the majority of the patients were 27.1% health workers and 24.8% business men, while the parent of the minority of the patients was 11.7% farmers and 16.4% industrial workers. Major indications for surgery were 52.3% obstructive sleep apnoea syndrome and 21.5% recurrent tonsillitis. Less common indications for surgery in this study were 1.4% persistent fever and 1.9% cardiopulmonary complications. There were 7.0% patients admitted as day cases and 93.0% patients admitted as an in-patient. Postoperatively, 1.4% of the day cases were admitted as inpatients while 1.9% of inpatients were treated as day cases. In this study, the established high risk factors include age less than 1 year 13.6%, Down syndrome 1.4%, craniofacial abnormalities 1.9%, malnutrition 10.7%, serum electrolyte and urea imbalance 10.3%, cardiovascular disease 3.7%, respiratory disease 7.5%, anaemia 8.9%, haemoglobinopathy 3.3% and


[1]  Owens, D., Fox, R., Harrison, W., Temple, M. and Tomkinson, A. (2011) Re: Improvement in Quality of Life by Adenotonsillectomy in Children with the Adenotonsillar Disease. Clinical Otolaryngology, 36, 281.
[2]  Olusesi, A.D., Undie, N.B. and Amodu, J.E. (2013) Allergy History as a Predictor of Early-Onset Adenoids/Adenotonsillar Nigerian Children. International Journal of Pediatric Otorhinolaryngology, 77, 1032-1035.
[3]  Afolabi, O.A., Alabi, B.S., Ologe, F.E., Dunmade, A.D. and Segun-Busari, S. (2009) Parental Satisfaction with Post-Adenotonsillectomy in the Developing World. International Journal of Pediatric Otorhinolaryngology, 73, 1516-1519.
[4]  Mitchell, R.B., Garetz, S., Moore, R.H., Rosen, C.L., Marcus, C.L., Katz, E.S., et al. (2015) The Use of Clinical Parameters to Predict Obstructive Sleep Apnea Syndrome Severity in Children: The Childhood Adenotonsillectomy (CHAT) Study Randomized Clinical Trial. JAMA Otolaryngology-Head & Neck Surgery, 141, 130-136.
[5]  Ahmed, A.O., Aliyu, I. and Kolo, E.S. (2014) Indications for Tonsillectomy and Adenoidectomy: Our Experience. Nigerian Journal of Clinical Practice, 17, 90-94.
[6]  Windfuhr, J.P. (2016) Indications for Tonsillectomy Stratified by the Level of Evidence. GMS Curr Top Otorhinolaryngol Head Neck Surg, 15, Doc09.
[7]  Bangera, A. (2017) Anaesthesia for Adenotonsillectomy: An Update. Indian Journal of Anaesthesia, 61, 103-109.
[8]  Domany, K.A., Dana, E., Tauman, R., Gut, G., Greenfeld, M., Bat-El, Y. and Sivan, Y. (2016) Adenoidectomy for Obstructive Sleep Apnea in Children. Journal of Clinical Sleep Medicine, 12, 1285-1291.
[9]  Baugh, R.F., Archer, S.M., Mitchell, R.B., Rosenfeld, R.M., Amin, R., Burns, J.J., et al. (2011) Clinical Practice Guideline: Tonsillectomy in Children. Otolaryngology-Head and Neck Surgery, 144, S1-S30.
[10]  Stelter, K. (2014) Tonsillitis and Sore Throat. GMS Curr Top Otorhinolaryngol Head Neck Surg., 13, Doc07.
[11]  Alsufyani, N., Isaac, A., Witmans, M., Major, P. and El-Hakim, H. (2017) Predictors of Failure of DISE-Directed Adenotonsillectomy in Children with Sleep-Disordered Breathing. Journal of Otolaryngology-Head & Neck Surgery, 46, 37.
[12]  Koshy, E., Bottle, A., Murray, J., et al. (2014) Changing Indications and Socio-Demographic Determinants of (Adeno)Tonsillectomy among Children in England—Are They Linked? A Retrospective Analysis of Hospital Data. PLoS ONE, 9, e103600.
[13]  Parker, N.P. and Walner, D.L. (2011) Trends in the Indications for Pediatric Tonsillectomy or Adenotonsillectomy. International Journal of Pediatric Otorhinolaryngology, 75, 282-285.
[14]  Grimes, C.E., Bowman, K.G., Dodgion, C.M. and Lavy, C.B. (2011) Systematic Review of Barriers to Surgical Care in Low-Income and Middle-Income Countries. World Journal of Surgery, 35, 941-950.
[15]  Lewallen, S. and Courtright, P. (2002) Gender and Use of Cataract Surgical Services in Developing Countries. Bulletin of the World Health Organization, 80, 300-303.
[16]  Briesen, S., Geneau, R., Roberts, H., Opiyo, J. and Courtright, P. (2010) Understanding Why Patients with Cataract Refuse Free Surgery: The Influence of Rumors in Kenya. Tropical Medicine & International Health, 15, 534-539.
[17]  Babademez, M.A., Gul, F., Muz, E., Muderris, T. and Hayati Kale, H. (2016) Impact of Partial and Total Tonsillectomy on Adenoid Regrowth. Laryngoscope, 127, 753-756.
[18]  Sharma, S., Andreoli, S. and Josephson, G.D. (2016) Tonsillectomy and Adenoidectomy: Current Techniques and Outcomes. International Journal of Head and Neck Surgery, 7, 104-108.
[19]  Southaven, A., Bhushan, B., Penn, E. and Billings, K.R. (2013) A Comparison of Revision Adenoidectomy Rates Based on Techniques. Otolaryngology—Head and Neck Surgery, 148, 841-846.
[20]  Kim, S.Y., Lee, W.H., Rhee, C.S., Lee, C.H. and Kim, J.W. (2013) Regrowth of the Adenoids after Coblation Adenoidectomy: Cephalometric Analysis. Laryngoscope, 123, 2567-2572.
[21]  Amutta, S.B. and Abdullahi, M. (2016) Adenoid and Tonsil Surgeries in Sokoto: A Nine-Year Review. International Journal of Innovative Research & Development, 5, 113-117.
[22]  Marcus, C.L., Brooks, L.J., Draper, K.A., et al. (2012) Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome: A Clinical Practice Guideline. Pediatrics, 130, 576-584.
[23]  Brigger, M.T. and Brietzke, S.E. (2006) Outpatient Tonsillectomy in Children: A Systematic Review. Otolaryngology—Head and Neck Surgery, 135, 1-7.
[24]  Cote, C.J., Posner, K.L. and Domino, K.B. (2013) Death or Neurologic Injury after Tonsillectomy in Children with a Focus on Obstructive Sleep Apnea: Houston, We Have a Problem! Anesthesia & Analgesia, 118, 1276-1283.
[25]  Goldman, J.L., Baugh, R.F., Davies, L., et al. (2013) Mortality and Major Morbidity after Tonsillectomy: Etiologic Factors and Strategies for Prevention. Laryngoscope, 123, 2544-2553.
[26]  Adegbiji, W.A., Aremu, S.K. and Lasisi, A.O. (2017) Patients Barrier to Ear, Nose and Throat Surgical Care in Nigeria. American Scientific Research Journal for Engineering, Technology, and Sciences, 32, 96-104.
[27]  Adegbiji, W.A., Aremu, S.K., Nwawolo, C.C. and Asoegwu, C.N. (2017) Current Trends of Adenotonsillar Hypertrophy Presentation in a Developing Country, Nigeria. International Journal of Otorhinolaryngology and Head and Neck Surgery, 3, 501-505.
[28]  Windfuhr, J.P. (2016) Specified Data for Tonsil Surgery in Germany. GMS Current Topics in Otorhinolaryngology—Head and Neck Surgery, 15, Doc08.
[29]  Kocyigit, M., Ortekin, G.S., Cakabay, T., Ustun Bezgin, S. and Serin Keskinege, B. (2017) Relation between the Type of Hospitals and the Decision of Adenotonsillectomy Indication. Journal of Craniofacial Surgery, 28, e377-e381.
[30]  Ameye, S.A., Owojuyigbe, A.M., Adeyemo, A., Adenekan, A.T. and Ouche, S. (2016) Pediatric Adenotonsillectomy Inalow Resource Setting: Lessons and Implications. Nigerian Journal of Surgery, 22, 77-80.
[31]  Hoddeson, E.K., Gourin, C.G., Augusta, G.A. and Baltimore (2009). Adult Tonsillectomy: Current Indications and Outcomes. Otolaryngology—Head and Neck Surgery, 140, 19-22.


comments powered by Disqus

Contact Us


微信:OALib Journal