Impact of obesity on operative time in pediatric adenotonsillectomy
Ear, Nose & Throat Journal, 2026
As pediatric obesity and sleep-disordered breathing continue to rise, understanding how obesity affects adenotonsillectomy workflow and perioperative care has become increasingly important. In this retrospective cohort of 499 children undergoing adenotonsillectomy, obese patients had significantly longer induction (15.2 vs 13.5 minutes, p<.0001), operative (21.1 vs 18.0 minutes, p=0.001), emergence (11.8 vs 9.3 minutes, p<.0001), and total operating room times (48.1 vs 40.7 minutes, p<.0001) compared to non-obese patients. On multivariable analysis, obesity independently increased induction time (β 1.69, 95% CI 0.84-2.54, p<.001), operative time (β 2.37, 95% CI 0.38-4.36, p=0.020), emergence time (β 2.21, 95% CI 1.08-3.33, p<.001), and total operating room time (β 6.27, 95% CI 3.74-8.80, p<.001). These findings demonstrate that obesity meaningfully increases perioperative demands during pediatric adenotonsillectomy and support tailored scheduling, perioperative planning, and counseling for higher-risk patients.
Recommended citation: Anandan D, Habib DRS, Whigham AS. Impact of obesity on operative time in pediatric adenotonsillectomy. Ear Nose Throat J. 2026. doi:10.1177/01455613261455100