Children with developmental delays may have higher rates of complications after tonsillectomy than children without developmental delays, according to a published study. International Journal of Pediatric Otorhinolaryngology Anthony Sheyn, MD, FACS, Chief of Otolaryngology at Le Bonheur Children’s Hospital.
What is developmental delay?
Developmental delay (DD) is a broad term for a range of problems characterized by difficulties in communication, gross and fine motor skills, problem solving and social relationships. Children with DD often have complex medical histories and comorbidities that require more medical treatment than children without DD.
“We have limited literature examining the effects of DD in pediatric surgical patients,” Shane said. “We wanted to further investigate the role that DD plays as a result of tonsillectomy, our most commonly performed pediatric surgery.”
Association between postoperative complications and developmental delay
Researchers reviewed the medical records of 400 tonsillectomy patients and compared postoperative complication rates between children with and without DD. DD was diagnosed in 56 (13.9%) of these individuals.
According to the findings, patients with DD had a higher risk of postoperative problems and experienced significantly more respiratory problems such as respiratory arrest and nocturnal oxygen desaturation. Only 8.72% of non-DD subjects experienced problems after surgery, compared to 32.14% of DD patients. Postoperative bleeding, dehydration, and vomiting were other problems.
In addition, individuals with moderate to severe DD experienced more postoperative problems than patients with mild DD. Severe patients had Down syndrome, Global Developmental Delay, or two or more developmental stage deficits. In the severe DD category, nine out of thirteen patients (69.23%) experienced postoperative complications.
Importance of preoperative planning in children with developmental delay
This study highlights the importance of comprehensive preoperative planning for patients with DD to reduce the risk of postoperative complications. The researchers believe that patients with moderate to severe DD are more likely to need therapy, but further studies are needed to characterize the severity of DD and how it affects surgical outcomes.
“This high risk of complications should be included in preoperative counseling and has potential implications for preoperative decision-making and treatment plans in this high-risk population,” he said. “We offer these patients comprehensive counseling and close follow-up after surgery to help mitigate the current findings of an increased complication rate.”