Weight Gain in Obese Children After Intracapsular Tonsillectomy.

OBJECTIVES

To analyze short-term weight gain among obese children after intracapsular tonsillectomy.

METHODS

A retrospective cohort included all children with a body mass index (BMI) > 95th percentile obtaining intracapsular tonsillectomy between 2021 and 2023 at a tertiary children's hospital. Measurements at least 30 days and at least 90 days postoperatively were recorded. BMI was expressed as a percentage of the 95th percentile (%BMIp95) and grouped by initial %BMIp95 ≤ 120 (class I obesity) or %BMIp95 > 120 (class II and III obesity).

RESULTS

There were 68 children that underwent intracapsular tonsillectomy at a mean age of 7.2 years (SD: 3.8) with obstructive breathing indications for 91% ( = 62). Mean %BMIp95 at surgery was 121 (95% confidence interval [CI]: 117-125). Class I obesity was noted for  = 39 (57%) and class II/III obesity was noted for  = 29 children (43%). At a mean of 6.9 months (SD: 5.3), the change in %BMIp95 was 1.77 (95% CI: -1.03 to 4.57) for class I and 3.27 (95% CI: 0.55 to 6.00) for class II/III obese children ( = 0.45). Measurements at least 90 days after surgery (mean: 12.8 months (SD: 5.2) showed no differences in %BMIp95 change between children with class I (1.17; 95% CI: -3.63 to 5.96) and class II/III obesity (3.00; 95% CI: -2.25 to 8.25) ( = 0.60).

CONCLUSION

Weight gain after intracapsular tonsillectomy was similar between children with low and high obesity class. Consistent growth trajectories continued beyond 3 months, suggesting intracapsular tonsillectomy may be an appropriate technique to address obstructive breathing in obese children.

LEVEL OF EVIDENCE

III.