March 15 (UPI) -- Healthy children younger than 3 who have had their tonsils removed may have a greater risk for complications than older children, according to a study.
In the United States, tonsillectomy is the second most common pediatric surgery performed, including 530,000 procedures performed on children younger than 15 each year, according to the American Academy of Otolaryngology-Head and Neck Surgery Foundation.
Researchers examined the medical data for 1,817 children ages 3 to 6 who underwent a tonsillectomy between 2005 and 2015 at five centers in New Orleans. Their findings were published Thursday in the Journal of the American Medical Association.
The researchers said this study represents the largest review of tonsillectomy complications in healthy children 6 years and younger. Possible complications include respiratory distress, dehydration requiring intravenous fluids and bleeding.
Excluded from the study were children with moderate to severe developmental delay, bleeding disorders and other major medical conditions.
"Our data suggest that complications are independent of weight in these patients," researchers wrote in the study. "In our cohort, those patients selected for overnight observation were associated with an increased number of adverse events following tonsillectomy, suggesting that clinician judgment is crucial in determining which patients are safe for outpatient tonsillectomy."
Among children younger than 3 years old, 7 percent developed complications, including 25 percent of them within 24 hours after surgery. For those having a tonsillectomy after age 3, it was 4.6 percent total complications, including 9.5 percent within 24 hours.
"There are two predominant reasons for removing tonsils and/or adenoids in children," said Dr. Gurpreet Ahuja, of the Children's Hospital of Orange County, Calif. "The primary reason is obstruction, or difficulty breathing, sleep-disordered breathing or sleep apnea. The second reason is recurring infection."
Diagnoses that were linked infectious causes, such as chronic tonsillitis, recurrent tonsillitis or peritonsillar abscess, were the primary reason for surgery in 44.8 percent of the patients. Diagnoses relating to sleep disordered breathing were present in 44.3 percent. A total of 14.3 percent had both and 25.3 percent had another disorder.
A greater percentage of the younger children had sleep disordered breathing than the older ones, the researchers found.