IS OUTPATIENT TONSILLECTOMY APPROPRIATE FOR YOUNG-CHILDREN

The current literature suggests that outpatient tonsillectomy is a saf e, cost-effective procedure, These reports have based their conclusion s on the low rates of postoperative bleeding and dehydration. Generall y, they have not examined other factors that may influence the postope rative course or identified groups of patients in whom outpatient mana gement may not be appropriate. The literature regarding tonsillectomy in young children is conflicting. A retrospective analysis of the reco rds of 223 children, 36 months of age and younger who had tonsillectom ies, was performed. Postoperative airway complications including oxyge n desaturation and airway obstruction developed in 115 patients. Seven teen (7.6%) children required postoperative care in an intensive care unit while an additional 117 (52.5%) patients received more than stand ard management. Preoperative apnea, an age of less than 12 months, and the presence of accompanying medical conditions were associated with a higher incidence of postoperative airway complications. It is recomm ended that tonsillectomy in patients under 36 months of age be planned as an inpatient procedure.