{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:20:30Z","timestamp":1763036430618},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2009,7,31]],"date-time":"2009-07-31T00:00:00Z","timestamp":1248998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives\/Hypothesis:<\/jats:title><jats:p>Children with neurologically impaired (NI) swallow can undergo tonsillectomy safely and effectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design:<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Forty\u2010five children with documented dysphagia were compared to age\u2010 and procedure\u2010matched normal children for operating room and clinical experience. Three further studies were limited to the NI children only: preoperative and postoperative video swallow studies (VSS), and polysomnography (PSG) for sleep\u2010disordered breathing history. Long\u2010term telephone follow\u2010up of clinical outcomes was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>There were no differences between the two groups measured by tonsil size or intraoperative or late post\u2010tonsillectomy hemorrhage, but lowest measured oxygen levels were statistically different. No intraoperative complications, early post\u2010tonsillectomy hemorrhage, hospital readmission, or mortality occurred in either group. Three NI children each had an episode of aspiration pneumonia (early or late) without sequelae. Of the 32 VSS available for review, postoperative aspiration incidence was significantly improved, but with new\u2010onset aspiration occurring in five children. Of available matched pre\u2010 and postoperative PSG, 91% confirmed resolution of identified preoperative obstructive sleep apnea. Long\u2010term telephone follow\u2010up of 20 NI children revealed improved breathing (95%), communication (90%), and feeding efficiency (55%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>This study suggests tonsillectomy in NI children can be performed safely with appropriate monitoring and precautions with a 48\u2010hour hospital postoperative stay recommended. Swallowing safety appears to improve both objectively and subjectively in most NI children following tonsillectomy. Both preoperative and postoperative VSS are recommended for any NI child undergoing tonsillectomy. Long\u2010term follow\u2010up identified improved quality of life measures for the majority of the NI children queried. 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