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The Association between Adenotonsillectomy and Frequency of Vaso-Occlusive Crises in Patients with Sickle Cell Disease

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Sickle cell disease (SCD) typically manifests in early childhood as attacks of pain known as vaso-occlusive crises. Infection and hypoxemia have been linked with these recurrent episodes and with prolonged hospitalization in SCD patients. However, adenoids and tonsils as sources of infection and causes of hypoxemia have not been adequately investigated in association with vaso-occlusive crises in SCD. To assess the association between adenotonsillectomy and frequency of vaso-occlusive crisis in SCD patients who underwent this procedure at our Hospital, and between adenotonsillectomy and frequency of blood transfusions and emergency department and intensive care unit admissions. We used medical record data to conduct a retrospective review of SCD patients who underwent adenoidectomy and/or tonsillectomy between 2005 and 2017. Eligible subjects were assessed for frequency of vaso-occlusive crises, blood transfusions, and emergency department and intensive care unit admissions. Using the Wilcoxon signed rank test, we compared the frequencies of each outcome preoperatively and 1, 3, 5, and 10 years postoperatively. Of 524 records reviewed, 40 eligible patients were included in the study. Minimal reduction was observed in the frequency of vaso-occlusive crisis episodes within 1 and 3 years after adenotonsillectomy (p = 0.337 and p = 0.549, respectively). Although the 5- and 10-year postoperative vaso-occlusive crisis frequency tended to be higher than that in the preoperative period, none of the results reached statistical significance. The number of emergency department admissions showed a statistically significant increase 3 years postoperatively compared with that in the preoperative period (P = 0.043). There were no statistically significant differences in perioperative blood transfusion frequency or number of intensive care unit admissions in any period. Adenotonsillectomy in SCD patients does not seem to be related to the frequency of vaso-occlusive crises, blood transfusions, or emergency department or intensive care unit admissions. Prospective studies with larger sample sizes are recommended to further evaluate these findings.

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Data Availability

The data sets used and analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

BT:

Blood transfusion

ED:

Emergency department

ICU:

Intensive care unit

RBC:

Red blood cell

SCD:

Sickle cell disease

VOC:

Vaso-occlusive crisis

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Acknowledgements

We would like to acknowledge Ghufran Abudawood, Hind Aseeri, LujainAlamoudi, Muradi Murad, and Waad Maher for their contributions to the data collection.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Otolaryngology—Head and Neck Surgery, Faculty of Medicine, , King Abdulaziz University, Jeddah, 21441, Saudi Arabia

    Hani Z. Marzouki, Lujain K. Abdalwassie & Talal Al-khatib

  2. Department of Dermatology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia

    Mawaddah A. Tallab

  3. Pediatric Nephrology Center of Excellence, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Osama Y. Safdar

  4. Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Fatma Alzharani & Fayza Alsiny

  5. Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia

    Nada J. Farsi

Authors
  1. Hani Z. Marzouki
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  2. Lujain K. Abdalwassie
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  3. Mawaddah A. Tallab
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  4. Talal Al-khatib
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  5. Osama Y. Safdar
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  6. Fatma Alzharani
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  8. Nada J. Farsi
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Contributions

All the authors contributed to the study design and conception and aided in the preparation of data retrieval. NF oversaw data collection, conducted the data analysis, interpreted the results, and did major revisions of all versions of the manuscript. LA and MT collected the data, wrote the manuscript, and interpreted findings. HM, FA, and OS conceptualized the research and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Talal Al-khatib.

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Conflict of interests

The authors declare that they have no conflict of interest.

Ethics Approval

The study protocol was reviewed and approved by Hospital Research Ethics Committee (document number 257–15). Data were kept confidential and all patients’ data were de-identified.

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Marzouki, H.Z., Abdalwassie, L.K., Tallab, M.A. et al. The Association between Adenotonsillectomy and Frequency of Vaso-Occlusive Crises in Patients with Sickle Cell Disease. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 5499–5505 (2022). https://doi.org/10.1007/s12070-021-02696-5

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