Author(s)
Soumya Gupta
Ryan Meyer
Francesca Viola
Adrian Williamson MD
Mattie R. Rosi-Schumacher, MD
Steven W. Coutras, MD, FRACS
Michele M. Carr, MD, DDS, MEd, PhD
Affiliation(s)
West Virginia University; Jacobs School of Medicine and Biomedical Sciences at the State University of New York at Buffalo; SUNY University at Buffalo, Dept of Otolaryngology;
Abstract:
Introduction: Lingual tonsillectomy is an uncommon procedure with little previous work done on its complications. Our goal was to describe contributors to prolonged length of stay (LOS).
Methods: A retrospective analysis of patients who underwent lingual tonsillectomy with CPT code 42870 was performed utilizing the American College of Surgeons National Surgery Quality Improvement Program database (2014-2019). Clinical variables analyzed included demographics, co-morbidities, complications, LOS, readmission, and reoperation.
Results: 162 patients (70 (43.2%) males and 92 (56.3%) females) were included.132 (81.5%) were White, 15 (9.3%) were Black, and the remainder were other races or not indicated. 33 (20.4%) were smokers, significantly more common among males (33% versus 11% of females, p=.001). 22 (13.6%) were diabetic and 56 (34.6%) had hypertension treated with medications. Mean age was 52.1 (95% CI 49.8-54.3 yr), mean BMI was 31.4 (95% CI 30.4-32.5). 39 (24.1%) had a diagnosis of malignancy. Complications were rare, pneumonia in 3 (1.9%), reintubation in 2 (1.2%), ventilation >48 hr in 2 (1.2%), CPR, sepsis, and UTI in 1 (0.6%) each. No bleeding was recorded. Median ASA class was 2. 2 (1.2%) returned to OR for related reasons, and 1 (0.6%) was readmitted for related reasons. Mean LOS was 1 day (95% CI 0.7-1.4 days, range 0-19). Linear regression showed that contributors to prolonged LOS included postop pneumonia (ß=5.3, p
Conclusions: This small multi-institutional study shows that patients with diabetes or a smoking history are most at risk of prolonged LOS after lingual tonsillectomy.