Reduced mouth opening following tonsillectomy in children: myth or reality.

OBJECTIVE To evaluate whether tonsillectomy in children leads to subsequent reduction in mouth opening. STUDY DESIGN Cohort study. PLACE AND DURATION OF STUDY Department of ENT/Head and Neck Surgery, Combined Military Hospital, Peshawar, from October 2005 to December 2006. METHODOLOGY A total of 42 children undergoing tonsillectomy (Group A = requiring insertion of a mouth gag) and 44 patients undergoing myringotomy or septoplasty (Group B = control group) were included in this cohort double blind study. Patients having pre-operative temporomandibular joint (TMJ) dysfunction, undergoing any other surgery in addition to tonsillectomy e.g. adenotonsillectomy, aged under 4 or above 15 years, and patients lost to follow-up were excluded. Painless, maximum interincisal distance (MID) was measured pre-operatively with a Vernier Calliper. Because of the inconsistency of mouth opening in children, three readings per individual were taken and the maximum recorded. Patients were followed up at 1, 2, 4, 12 and 26 weeks postoperatively in the ENT OPD and respective MID readings recorded. RESULTS After a transient reduction in mouth opening, at the 26th week follow-up, 100% patients had reverted to their preoperative MID measurements. CONCLUSION Reduced mouth opening in children, after tonsillectomy is a transient finding returning to normal by about the 26th postoperative week.