Tonsillectomy increases the risk of retropharyngeal and parapharyngeal abscesses in adults, but not in children: A national cohort study

So Young Kim; Chanyang Min; Woo Hyun Lee; Hyo Geun Choi

doi:10.1371/journal.pone.0193913

Tonsillectomy increases the risk of retropharyngeal and parapharyngeal abscesses in adults, but not in children: A national cohort study

PLoS One. 2018 Mar 6;13(3):e0193913. doi: 10.1371/journal.pone.0193913. eCollection 2018.

Authors

So Young Kim¹, Chanyang Min², Woo Hyun Lee³, Hyo Geun Choi⁴

Affiliations

¹ Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
² Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.
³ Department of Otorhinolaryngology, National Police Hospital, Seoul, Korea.
⁴ Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.

Abstract

Objectives: The 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.

Methods: Using 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).

Results: The 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.

Conclusion: The 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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Abscess / epidemiology
Abscess / etiology*
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Case-Control Studies
Child
Child, Preschool
Cohort Studies
Humans
Infant
Infant, Newborn
Middle Aged
Pharyngeal Diseases / epidemiology
Pharyngeal Diseases / etiology*
Proportional Hazards Models
Republic of Korea / epidemiology
Retropharyngeal Abscess / epidemiology
Retropharyngeal Abscess / etiology*
Risk Factors
Tonsillectomy / adverse effects*
Young Adult

Grants and funding

This work was supported in part by a research grant (NRF-2015-R1D1A1A01060860) from the National Research Foundation (NRF) of Korea. There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.