Children with developmental delay may have higher complication rates following tonsillectomy than children without developmental delay, according to research published in the International Journal of Pediatric Otorhinolaryngology by Anthony Sheyn, M.D., FACS, chief of Otolaryngology at Le Bonheur Children’s Hospital.
What is Developmental Delay?
Developmental delay (DD) is a wide term for a range of problems characterized by difficulties with communication, gross and fine motor abilities, problem-solving, and social relationships. Children with DD frequently have complex medical histories and comorbidities, necessitating more healthcare treatment than children without DD.
“We have a limited amount of literature studying the effect of DD in pediatric surgical patients,” said Sheyn. “We wanted to further investigate the role that DD has on the outcome of our most performed pediatric surgery, tonsillectomy.”
Link between Post-Operative Complications and Developmental Delay
Researchers compared postoperative complication rates between children with and without DD by reviewing medical data from 400 tonsillectomy patients. 56 (13.9%) of these individuals were diagnosed with DD.
Patients with DD had a much higher risk of post-operative problems and experienced significantly more respiratory issues, such as respiratory arrest and nocturnal oxygen desaturation, according to the findings. Just 8.72% of individuals without DD suffered a problem following surgery, compared to 32.14% of patients with DD. Post-operative bleeding, dehydration, and vomiting were other problems.
Furthermore, individuals with moderate to severe DD were more likely to experience post-operative problems than patients with mild DD. Severe patients had Down syndrome, Global Developmental Delay, or two or more developmental milestone deficits. In the severe DD category, nine out of thirteen patients (69.23%) had a problem following surgery.
Importance of Pre-Operative Planning in Children with Developmental Delay
This study underlines the importance of thorough pre-operative planning for patients with DD to reduce the risk of post-operative problems. Researchers believe that patients with moderate to severe DD have a greater need for therapy, but additional research is needed to characterize DD severity and how it affects surgical results.
“This elevated risk of complications should be included in pre-operative counseling and has potential implications for pre-operative decision-making and treatment plans in this high-risk population,” said Sheyn. “We suggest in-depth counseling and close follow-up after surgery for these patients to help reduce the current findings of an increased complication rate.”