Adult tonsillectomy: An evaluation of indications and complications

• Published in: American journal of otolaryngology Vol. 43; no. 3; p. 103403
• Main Authors: Patel, Shivam D., Daher, Ghazal S., Engle, Linda, Zhu, Junjia, Slonimsky, Guy
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2022; Elsevier Limited
• Subjects: Adult; Adults; Age; Airway management; Alcohol; Antibiotics; Apnea; Biopsy; Bleeding; Comorbidity; Complication; Complications; Demographics; Emergency medical care; Emergency medical services; Etiology; General anesthesia; Hemorrhage; Indication; Males; Medical records; Multivariate analysis; Otolaryngology; Patients; Pediatrics; Population; Post-tonsillectomy hemorrhage; Postoperative; Regression analysis; Regression models; Risk analysis; Risk factors; Sex; Sleep apnea; Sleep disorders; Statistical analysis; Stone; Surgery; Throat surgery; Tonsil; Tonsillectomy; Tonsillitis; Tonsillolith; Trends; Tumors; United States > US; Tonsillolith; Complication; Adult; Tonsillectomy; Post-tonsillectomy hemorrhage
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2022.103403

This study aimed to evaluate current adult tonsillectomy indications along with risk factors associated with postoperative complications.
In this retrospective chart review, demographic, clinical, and surgical data were collected from 2004 to 2020 of adult patients who underwent tonsillectomy. Indications for surgery were categorized as infectious etiology, biopsy, obstructive sleep apnea (OSA), and tonsillar stones. Data regarding postoperative hemorrhage, emergency department (ED) visits, and readmissions were collected. Multivariable logistic regression models were used to evaluate factors associated with postoperative complications.
574 adults (mean age 32 years, 69.9% F vs. 30.1% M) were included. The most common indication was infections (62.2%), followed by biopsy (26.5%), tonsillar stones (6.8%), and OSA (4.5%). The highest frequency of postoperative bleeds (17.9%) occurred in the tonsillar stones cohort; however, the indication for surgery was not a significant predictor on multivariate analysis. Male sex and younger age were independent predictors of postoperative bleeding, while younger age was a significant predictor of postoperative ED visits. There was a significant linear trend of an increasing proportion of tonsillectomies performed for tonsillar stones compared to other indications for 2011–2019.
Infectious etiology was the most common indication for tonsillectomy. Indication for surgery was not a significant predictor of postoperative bleeding; however, male sex and younger age had higher odds of postoperative bleeding. The proportion of tonsillectomies performed for tonsillar stones was steadily increasing.