Auditing adenotonsillectomy: The Makurdi, North Central Nigeria, experience

Abstract

Background: Adenoidectomy, tonsillectomy, or both are a leading cause of surgical admission, especially in children, in otolaryngological practice in the world. This study aimed to audit the demography, symptoms/signs, indications, types of surgery, postoperative outcome, and histopathological evaluation of adenotonsillectomy in Makurdi, Nigeria. Methods: This was a 3-year retrospective study. Record of total surgical procedures was taken and data of patients who had adenoidectomy, tonsillectomy, or both were retrieved. The data extracted included study population demography, symptoms/signs, indication and surgery carried out, postoperative care, and histopathological reports of specimens. The primary outcomes were symptoms/signs, indication, and type of surgery, whereas postoperative management and histopathological examination findings were secondary consideration. Ethical clearance was obtained. The data were analyzed. Results: Two hundred and twenty different types of surgeries were done within the study period. Seventy-two patients (32.7%) underwent adenoid and tonsil surgeries, comprising 46 males and 26 females; age ranged from 1 to 38 years with mean age of 6.63 ±7.78 years. Majority (68.0%) of the patients were ≤5 years old. Snoring and noisy breathing were common presentations. Obstructive adenotonsillar hypertrophy at 63.9% was the most frequent indication for surgery and adenotonsillectomy constituted the most performed procedure. Postoperatively, all the patients had routine antibiotics, analgesics, and were commenced on graded oral feeds. Nine (12.5%) and six (8.3%) patients had postoperative vomiting and fever, respectively. There were no complications of hemorrhage or fatality. The patients were kept for 2 to 3 days. Histopathology results showed follicular hyperplasia (61.1%) and chronic inflammation (38.9%). Conclusion: Adenoid and tonsillar surgeries still constitute common procedures among children in Makurdi and obstructive adenotonsillar hypertrophy and its surgery is commonly encountered with satisfactory outcome. Routine histopathological examination of nonsuspicious adenoid and tonsil specimens should be discouraged.