Abstract
ObjectivesThe purpose of this study is to evaluate the risk of retropharyngeal and parapharyngeal abscesses (deep neck infection) after tonsillectomy in Koreans using national cohort data.MethodsUsing the national cohort study from the Korean Health Insurance Review and Assessment Service, participants who had undergone a tonsillectomy (5,299) and control participants (21,196) were selected and matched 1:4 (for age, sex, income, region of residence, and pre-operative upper respiratory infection visits). The Cox-proportional hazard model was used. A crude model and an adjusted model for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia were used in this analysis. For the subgroup analyses, the participants were divided into 2 groups: children (≤ 14 years old) and adolescents and adults (≥ 15 years old).ResultsThe adjusted hazard ratio of deep neck infection after tonsillectomy was 1.43 (95% confidence interval, CI = 1.18–1.72, P < 0.001). In subgroup analysis, this ratio was 1.12 (95% CI = 0.86–1.47, P = 0.390) in children and 1.87 (95% CI = 1.43–2.45, P < 0.001) in adolescents and adults. The crude hazard ratios were almost the same as the adjusted ratios.ConclusionThe risk of deep neck infection was higher in the tonsillectomy group. The subgroup analysis showed a similar finding in the adolescent and adult group but not in the child group.
Highlights
Tonsillectomy with/without adenoidectomy is one of the most common surgeries in children worldwide [1]
The adjusted hazard ratio of deep neck infection after tonsillectomy was 1.43 (95% confidence interval, CI = 1.18–1.72, P < 0.001)
The risk of deep neck infection was higher in the tonsillectomy group
Summary
Tonsillectomy with/without adenoidectomy is one of the most common surgeries in children worldwide [1]. The rate of tonsillectomy in those under 18 years old is 3.4 to 4.8 per 1,000 people in the US [2, 3]. Our previous study reported this rate to be 2.58 per 1,000 people under 16 years old in Korea [4]. The tonsils and adenoids are lymphoid tissues of Waldeyer’s ring. They are involved in the defense against antigens of the upper respiratory tract [5, 6]. Retropharyngeal or parapharyngeal infection (deep neck infection) is a serious condition involving the parapharyngeal space of the neck, which is enclosed by deep fascia, and originates from an upper aerodigestive tract infection [7]. Few studies have reported the possibility of deep neck infection after tonsillectomy
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