Postoperative complications in children with clinically diagnosed sleep-disordered breathing undergoing tonsillectomy

BACKGROUND: Children with clinically diagnosed sleep-disordered breathing (SDB)are at higher risk of respiratory complications following tonsillectomy. Decision to admit for surveillance post-operatively depends on variable patient-related factors. Further studies to find additional considerations can help refine the decision-making process, ultimately improving patient safety. AIMS/OBJECTIVES: To compare the rate of post-operative respiratory complications (PoRCs) between different surgical techniques and methods in children with clinically diagnosed SDB undergoing tonsillectomy. MATERIAL AND METHODS: A retrospective study was conducted, including 139 children aged 6 months to 18 years who underwent tonsillectomy between January 2021 and June 2024 at three hospitals in Lebanon. Patients were compared according to postoperative respiratory complication status: 45 patients with PoRCs and 94 without PoRCs. RESULTS: Undergoing the cautery method compared to coblation, undergoing total vs partial tonsillectomy, and higher ventilation rate had a significant association with higher odds of PoRCs. CONCLUSIONS AND SIGNIFICANCE: In children with clinically diagnosed SDB undergoing tonsillectomy, the surgical technique, method, and airway management were significantly associated with the rate of PoRCs. Adequate choice of technique and method may be associated with reduced PoRCs in children with clinically diagnosed SDB undergoing tonsil surgery. These findings can assist clinicians in making informed decisions regarding post-operative care to reduce risks and improve clinical outcomes.