Is it safe to perform adenotonsillectomy in children with Down syndrome?

YUMUŞAKHUYLU A. C., Binnetoglu A., Demir B., Baglam T., Sari M.

EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, cilt.273, sa.9, ss.2819-2823, 2016 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 273 Sayı: 9
  • Basım Tarihi: 2016
  • Doi Numarası: 10.1007/s00405-016-4012-7
  • Dergi Adı: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.2819-2823
  • Anahtar Kelimeler: Down syndrome, Tonsillectomy, Adenoidectomy, Complication, Bradycardia, Obstructive sleep apnea, OBSTRUCTIVE SLEEP-APNEA, AIRWAY-OBSTRUCTION, ADENOIDECTOMY, TONSILLECTOMY, SEVOFLURANE, INSTABILITY, TRISOMY-21, INDUCTION, PATTERNS
  • Marmara Üniversitesi Adresli: Evet

Özet

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.