A prospective cohort study exploring the impact of tonsillectomy on
feeding difficulties in children
Abstract
Objectives Paediatric feeding difficulties are common,
affecting up to 25% of otherwise healthy children, symptoms include
food refusal, gagging, choking, and excessive mealtime duration. These
symptoms are commonly described in pre-operative discussions about
tonsillectomy. This prospective study explores the impact of
tonsillectomy on paediatric feeding difficulties. Methods This
prospective cohort study invited caregivers of all children undergoing
tonsillectomy at our institution to complete a PediEAT questionnaire
about their children’s feeding behaviours, pre and post-operatively. The
study was completed in two phases with 9 questions administered in phase
1 and three additional questions added for phase 2. A free text comments
box was also provided. Responses were graded from 0-5, where 0 is ‘never
a problem’ and 5 is ‘always a problem’ with eating behaviours.
Results 102 participants were recruited between January 2020 –
January 2022. The mean age of participants was 4.1 years, 87% had a
concurrent adenoidectomy. The mean time to completion of post-operative
questionnaire was 23 weeks after surgery. 9 of the 12 questions showed a
statistically significant improvement in post-operative scores using a
paired student t-test (p=<0.05). The most significant
improvements related to “gets tired from eating and is unable to
finish” (1.49 pre-op, 0.91 post op, p<0.01) and “eats food
that needs to be chewed” (1.4 pre-op, 0.72 post-op, p<0.01).
13% of participants only underwent tonsillectomy and this group also
showed a statistically significant improvement in fatigue during eating
(p<0.05). Conclusion Symptoms of fatigue during
eating and avoidance of food requiring mastication are most likely to
improve following tonsillectomy in children.