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Child Obes 2022 Jul 1. Epub 2022 Jul 1.

Departments of Pediatrics and Surgery, Mount Sinai Health System, New York, NY, USA.

While multiple studies have documented that obesity increases the risk of operative complications among adults, little data exist on how obesity impacts surgical outcomes among children. We aimed to determine if children with obesity have different postoperative outcomes than their peers. A retrospective chart review was conducted of 875 patients aged between 2 and 18 years who underwent surgery during 2018. Read More

JAMA Netw Open 2022 Jun 1;5(6):e2219701. Epub 2022 Jun 1.

Michigan Opioid Prescribing Engagement Network, University of Michigan Medical School, Ann Arbor.

Importance: In prior studies, decreasing the default number of doses in opioid prescriptions written in electronic health record systems reduced opioid prescribing. However, these studies did not rigorously assess patient-reported outcomes, and few included pediatric patients.

Objective: To evaluate the association between decreasing the default number of doses in opioid prescriptions written in electronic health record systems and opioid prescribing and patient-reported outcomes among adolescents and young adults undergoing tonsillectomy. Read More

Rev Assoc Med Bras (1992) 2022 24;68(6):775-779. Epub 2022 Jun 24.

Zhongshan Hospital Affiliated to Xiamen University, Department of Otorhinolaryngology Head and Neck Surgery - Xiamen, China.

Objective: This study aimed to compare the perioperative indicators, treatment efficacy, and postoperative complications between tonsillotomy and tonsillectomy for children with obstructive sleep apnea hypopnea syndrome.

Methods: A total of 134 children with obstructive sleep apnea hypopnea syndrome were divided into tonsillotomy group (n=66) and tonsillectomy group (n=68). The tonsillotomy group received tonsillotomy treatment with a power cutter, while the tonsillectomy group received tonsillectomy treatment. Read More

Eur J Transl Myol 2022 Jun 29. Epub 2022 Jun 29.

Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan.

Laryngospasm is an important complication of tonsillectomies. This study aimed to compare the effects of propofol versus lidocaine on prevention of laryngospasm in tonsillectomy. This randomized clinical trial included 102 patients who met the inclusion criteria. Read More

Int J Pediatr Otorhinolaryngol 2022 Jun 13;159:111206. Epub 2022 Jun 13.

Department of Otolaryngology, Penn State Milton S Hershey Medical Center, 500 University Drive, Hershey, PA, United States.

Objectives: Transoral robotic surgery in adults confers excellent results and decreased morbidity. Application of these techniques has not yet been rigorously investigated in children. The goal of this study is to evaluate the feasibility of a flexible robotic surgical system in a pediatric population. Read More

BMC Vet Res 2022 Jun 24;18(1):242. Epub 2022 Jun 24.

Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, 750 07, Uppsala, Sweden.

Background: Canine tonsillectomy is performed due to acute or chronic tonsillitis, neoplasia, trauma or occasionally brachycephalic obstructive airway syndrome. Several tonsillectomy techniques are used but information about surgical complications is scarce. This retrospective study of patient records at the University Animal Hospital aimed to investigate complications related to canine tonsillectomy performed by 20-min clamping combined with monopolar electrosurgery. Read More

Int J Pediatr Otorhinolaryngol 2022 Jun 12;159:111209. Epub 2022 Jun 12.

Children's Healthcare of Atlanta at Egleston, Atlanta, GA, USA; Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. Electronic address:

Introduction: Opioid prescribing patterns after pediatric tonsillectomy are highly variable, and opioids may not improve pain control compared to over-the-counter pain relievers. We evaluated whether a standardized, opioid-sparing analgesic protocol effectively reduced opioid prescriptions without compromising patient outcomes.

Methods: A quality improvement project was initiated in July 2019 to standardize analgesic prescribing after hospital-based tonsillectomy with/without adenoidectomy. Read More

Int J Environ Res Public Health 2022 Jun 17;19(12). Epub 2022 Jun 17.

Brandenburg Medical School (Theodor Fontane), 16816 Neuruppin, Germany.

A new Second Opinion Directive (SOD) was introduced in Germany in December 2018 for hysterectomy, tonsillotomy, and tonsillectomy to support shared decision making and to avoid unnecessary surgeries. Owing to its recent implementation, evidence and insights regarding outcomes and challenges encountered with the SOD are lacking, notably from the physicians' perspective. To assess this, we undertook an exploratory sequential mixed-methods design with an initial qualitative phase followed by a quantitative evaluation. Read More

Laryngorhinootologie 2022 Jul 23;101(7):620-623. Epub 2022 Jun 23.

Laryngoscope Investig Otolaryngol 2022 Jun 29;7(3):707-714. Epub 2022 Mar 29.

Department of Otolaryngology-Head and Neck Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China.

Objective: The aim of this study was to compare intraoperative blood loss, postoperative pain, post-tonsillectomy hemorrhage (PTH), and medical costs associated with extracapsular tonsillectomy between coblation and monopolar electrocautery in children.

Materials And Methods: This study included 293 patients aged 6-15 years planned to undergo extracapsular tonsillectomy. Data on estimated blood loss, postoperative pain score, operation time, PTH, and the cost of disposable equipment were collected. Read More

Vet Surg 2022 Jun 22. Epub 2022 Jun 22.

From the Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA.

Objective: To determine the severity of nasopharyngeal collapse in brachycephalic dogs before and after corrective airway surgery.

Animals: Twenty-three brachycephalic dogs (21 with clinical signs referrable to the upper airway) and nine clinically normal nonbrachycephalic dogs (controls).

Methods: Dogs were evaluated with fluoroscopy awake and standing with the head in a neutral position. Read More

J Surg Res 2022 Jun 18;279:84-88. Epub 2022 Jun 18.

Division of Pediatric Surgery, Department of Surgery, University of California San Diego School of Medicine, San Diego, California. Electronic address:

Introduction: The purpose of this study was to analyze a nationwide database of malpractice lawsuits involving pediatric surgical patients to identify contributing factors in liability claims.

Methods: Using the CRICO (Controlled Risk Insurance Company Strategies' Comparative Benchmarking System) database, malpractice claims involving patients ≤18 y old were reviewed from 2008 to 2017. Data were analyzed using descriptive statistics and logistic regression. Read More

JAMA Otolaryngol Head Neck Surg 2022 Jun 21. Epub 2022 Jun 21.

Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk.

JAMA 2022 06;327(23):2292-2293

Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, Texas.

JAMA 2022 06;327(23):2317-2325

Division of Hospital Medicine, Department of Pediatrics, University of Wisconsin, Madison.

Importance: The rate of postoperative death in children undergoing tonsillectomy is uncertain. Mortality rates are not separately available for children at increased risk of complications, including young children (aged <3 y) and those with sleep-disordered breathing or complex chronic conditions.

Objective: To estimate postoperative mortality following tonsillectomy in US children, both overall and in relation to recognized risk factors for complications. Read More

J Am Acad Dermatol 2022 Jun 17. Epub 2022 Jun 17.

Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital; Institute of Medicine, Chung Shan Medical University, Taichung, 40203, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. Electronic address:

J Laryngol Otol 2022 Jun 16:1-26. Epub 2022 Jun 16.

Consultant Paediatric Otolaryngologist, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF.

BMJ Open 2022 Jun 15;12(6):e061651. Epub 2022 Jun 15.

Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Introduction: Obstructive sleep apnoea (OSA) is a sleep-breathing disorder that seems likely to have long-term negative social and health consequences in children and adolescents. There are no established standard management approaches when the first line of therapy, the tonsillectomy and adenoidectomy (T&A), is not indicated or fails to address paediatric OSA (residual paediatric OSA). This protocol describes a prospective cohort study that aims to assess the effectiveness of orthodontic interventions for managing residual paediatric OSA in patients with concomitant craniofacial issues. Read More

Rev Paul Pediatr 2022 10;40:e2021087. Epub 2022 Jun 10.

Universidade Positivo, Curitiba, PR, Brazil.

Objective: To describe clinical, diagnostic and therapeutic characteristics of the periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome.

Data Source: Literature review in the PubMed database by using specific descriptors to identify all articles published in the English language in the last three years; 38 articles were found. After performing selection of titles and abstract analysis, 13 out of the 38 articles were fully read. Read More

JA Clin Rep 2022 Jun 14;8(1):41. Epub 2022 Jun 14.

Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, Los Angeles, CA, 90027, USA.

Background: Children with severe obstructive sleep apnea (OSA) carry a higher risk of respiratory complications after adenotonsillectomy. Their altered sensitivity to opioids may be a significant contributor to respiratory morbidity. The purpose of this study was to identify how anesthesia without opioids affects perioperative opioid demand and postoperative course. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2022 Jun 7. Epub 2022 Jun 7.

Department of Otorhinolaryngology, Habib Bourguiba hospital, Sfax, Tunisia; University of Sfax, Sfax, Tunisia.

Objectives: The main objective of this study was to compare the wound infiltration (peritonsillar fossa) of magnesium sulphate combined with bupivacaine, bupivacaine alone and saline solution on post-tonsillectomy pain in children. The accessory objectives were to evaluate the effect of magnesium sulphate infiltration on prevention of laryngospasm and occurrence of nausea/vomiting.

Methods: This study is a prospective; double blinded and randomized clinical trial. Read More

Am J Otolaryngol 2022 Jun 6;43(5):103515. Epub 2022 Jun 6.

First Affiliated Hospital of Wenzhou Medical University, China. Electronic address:

Purpose: The aim of this study was to investigate the correlation between Helicobacter pylori colonization of tonsillar tissue in chronic tonsillitis and in noninfectious hyperplastic tonsils.

Materials And Methods: All included studies investigated the presence of Helicobacter pylori in tonsillar tissue removed for infectious or noninfectious factors. Included studies must have used an accepted method of testing for Helicobacter pylori. Read More

World J Clin Cases 2022 May;10(14):4594-4600

Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China.

Background: During the perianesthesia period, emergency situations threatening the life and safety of patients can occur at any time. When dealing with some emergencies, occasional confusion is inevitable.

Case Summary: This case report describes the rare situation wherein a surgeon inadvertently detached the inflatable tube of an endotracheal tube during a tonsillectomy, and positive pressure ventilation could not be provided. Read More

Clin Case Rep 2022 Jun 2;10(6):e05928. Epub 2022 Jun 2.

Department of Otolaryngology-Head and Neck Surgery Galway University Hospital Galway Ireland.

Foreign Accent Syndrome (FAS) is a rare clinical entity in which affected patients experience a new pattern of speech resembling an unusual accent. Reported cases are scarce in published literature and are usually the result of a neurological insult. FAS as a complication from a general anesthetic or surgery has not been reported to date. Read More

J Paediatr Child Health 2022 Jun 3. Epub 2022 Jun 3.

The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

Aim: To investigate the impact of adenotonsillectomy (ADT) and adenoidectomy (AD) on child health and evaluated their post-operative complications.

Methods: We included all children aged <16 years undergoing ADT (tonsillectomy ± adenoidectomy) or AD in New South Wales, Australia, 2008-2017. Health information was obtained from administrative hospitalisation data. Read More

Iran J Otorhinolaryngol 2022 Mar;34(121):113-120

Department of Surgery/Otolaryngology, College of Medicine, Tikrit University, Tikrit city, Iraq.

Introduction: The study aimed to compare the intra-individual 2 procedures of tonsillectomy (Coblation and diode laser) concerning the operative time, the amount of blood loss, postoperative pain, and other complications.

Materials And Methods: A comparative study was conducted at many Private Hospitals, Baghdad, Iraq from February 2019- February 2020. Coblation and diode laser tonsillectomy were performed on the same patient (one for each side) which was blinded to the patients or their caregivers and the surgeon who did the tonsillectomy. Read More

Iran J Otorhinolaryngol 2022 May;34(122):145-153

Otolaryngology Unit, Department of Biomedicine and Advanced Diagnostic, University of Palermo, Palermo, Italy.

Introduction: One of the most important complications of OSAHS in children is growth delay. The aim of this study was to investigate changes in clinical body growth, and laboratory growth in children with OSAHS after adeno-tonsillar surgery.

Materials And Methods: In our study, among 102 children suffering from sleep-disordered breathing, 70 met the inclusion criteria because they were affected by OSAHS and adenotonsillar hypertrophy. Read More

Zhonghua Yi Xue Za Zhi 2022 Jun;102(21):1584-1589

Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China.

To investigate the effects of high-flow nasal oxygen (HFNO) combined with early extubation on the incidence of respiratory adverse events (RAE) during emergence from general anesthesia in children undergoing adenoid-tonsillectomy. From December 2021 to January 2022, 40 pediatric patients [21 males, 19 females, with a median age of 4 (4, 5) years] undergoing tonsillectomy and/or adenoidectomy in Eye & ENT Hospital of Fudan University were randomly divided into two groups: HFNO-assisted early extubation group (Group H, =20) and conventional extubation group (Group C, =20) by using a random number table. After entering the post-anesthesia care unit (PACU), the patients in group H received humidified and heated oxygen (flow rate: 25 L/min) through a nasal cannula until their consciousness regained. Read More

J Lasers Med Sci 2022 16;13:e7. Epub 2022 Feb 16.

Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Postoperative management of patients undergoing tonsillectomy is challenging. Photobiomodulation therapy (PBMT) has emerged as a new tool providing therapeutic benefits. However, the contribution of PBMT to the postoperative outcomes of tonsillectomy is still undefined. Read More

Mod Rheumatol Case Rep 2022 May 27. Epub 2022 May 27.

Vasculitis Research Unit and Clinical Unit of Autoinflammatory Diseases, Department of Autoimmune Diseases, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.

Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome, a polygenic or multifactorial condition, is the most frequent autoinflammatory disease in children. There is increasing evidence that some patients may have a disease onset during adulthood. With regard to PFAPA syndrome treatment, single medium-to-high doses of glucocorticoids during flares constitute the therapy of choice in children and adults, colchicine may be useful in some patients and tonsillectomy has been reported of utility mainly in pediatric patients. Read More