Weight Gain after Tonsillectomy and Adenotonsillectomy: A Case Control Study

Abstract

Objectives:

(1) Compare height and weight changes of children who underwent tonsillectomy and adenotonsillectomy (T&A) with a control group. (2) Analyze differences in growth based on starting weight class.

Methods:

A total of 154 children who underwent T&A between December 2010 and March 2011 were included. They were compared with 182 children with similar demographics who were seen in primary care clinics (control). Height and weight were compared at 6-month intervals over a 24-month period. Patients were divided into normal weight, overweight, and obese based on Centers for Disease Control and Prevention criteria. A multilevel regression model was used for analysis. Significance was set at P = .05.

Results:

There were no differences in average starting weight, age, or sex between surgical and nonsurgical groups. Average starting weight was 47.6 kg (confidence interval [CI] 42.0-53.2) and 48.1 kg (CI 41.8-54.3) for the obese surgical and obese control groups respectively. There was no difference in weight gain at 6 months. However at 12, 18, and 24 months, the obese surgical group had a significant weight increase over and above the obese control group (P < .001). An average of 14.3 kg weight gain at 24 months was seen in obese children who underwent T&A compared to 10.1 kg for controls (a difference of 4.2 kg (±2.9)). There were no differences in weight changes between the normal and overweight groups or in height for any of the groups.

Conclusions:

T&A leads to significant increase in weight in obese but not in normal or overweight children. Efforts should be made to provide weight reduction counseling prior to T&A in obese children.