EVALUATION OF THE TONSILLECTOMY AND ADENOTONSILLECTOMY IMPLEMENTED PATIENTS WITH RESPECT TO INDICATIONS, COMPLICATIONS, POSTOPERATIVE CONSEQUENCES, AND ANTICIPATION-OUTCOME RELATIONS

Patients and Methods: Sixty-five pediatric patients with a ratio of 34 male (52.3%) and 31 female (47.7%) participated. All the participants have had either tonsillectomy or adenotonsillectomy operation in our clinic sometime from September, 2008 to October, 2011. The mean age of the patients was found as 7.09±2.30 (min. 4 - max. 13) preoperatively. All the patients were randomly chosen. Considering the patients' diagnosis; 11 (16.9%) of the total patients had chronic/hypertrophic tonsillitis, and remaining 54 (83.1%) patients had cronic/hypertrophic tonsillitis with adenoid vegetation. Anamnesis of all the patients who were called for follow-up were taken from the parents. The parents were asked to complete a survey which consists of 19 multiple choice or/and open ended questions. After survey, patients were examined and latest clinical findings were noted.

Results: Average length of postoperative follow-up was 15.18±7.7 months (min. 1 – max. 36). Our clinic being an university research institution was the most influential factor (55.4%) for those who had chosen this clinic for the operations. Findings indicated that; before making final decision on having the operation, patients had been consulted by an avarage of 2.55±1.87 (min 1- max. 10) specialist doctors. Affectiveness of the operations was found as 8.55±1.39 (min. 4 – max. 10) out of 10 point. Nine-teen (29.2%) patients have complained about ongoing problems; 36 (55.4%) of them have not had any complaint; and remaining 10 (15.4%) patients have reported being relatively better. According to the reports, although 39 (60%) of the patients preoperatively had growth defficiency in comparasion to their peers; postoperative reports have been claimed a noticable progress for 24 (61.5%) of growth defficiency suffering patients. On the other hand, 4 (6.2%) patients have reported regret of having the surgery. Twenty-five (38.5%) of the patients were preschool children and 1 (1.5%) was receiving special education. In addition to this, school success of 19 (29.2%) children has increased in an observable level; however, the success level has remained the same for remaining 20 (30.8%) children. The most frequently reported early postoperative semptoms were pain (35%), disphagy (32%), and lack of appetite (15%). No statistically significant relation found between both age – recovery time and type of operation – recovery time. In the cases of grouping patients according to gender, age, or diagnosis; no statistically significant results were found between recovery time, development of complications, and other variables.

Conclusion: As conclusion, before making a decision on whether performing an operation, followings need to be considered: More careful preoperative evaluations should be done, detailed investigation regarding patients' systemic diseases need to be done, expectations of patients should be precisely defined. It is observed that adenotonsillectomies performed on picked patients result in higher satisfaction. Keywords : Adenoid hipertrophy, chronic/recurrent tonsillit, tonsillectomy, satisfaction, indication, complication