# A Retrospective Review Exploring the Role of Gender and Frequency of Tonsillectomy, Adenoidectomy, and Tympanostomy in Pediatric Patients With Speech Delay

## TL;DR

This study finds that male children with speech delays are more likely to undergo ear and throat surgeries than females, with Caucasians and lower-income families having higher surgery rates.

## Contribution

The study identifies gender, ethnicity, and socioeconomic disparities in surgical interventions for pediatric speech delay.

## Key findings

- Male patients were 1.84 times more likely to undergo surgery than females.
- Caucasian children had the highest procedure rates, and most patients were from middle- or lower-income households.
- Tympanostomy was the most common procedure, with 60% of patients undergoing more than one surgery.

## Abstract

Background

Speech and language delays are common early childhood conditions that involve difficulty with sound formation and language comprehension. Factors that often contribute to these delays include hearing loss, oral impairments, and frequent ear and throat infections, among others. Otitis media is a common pediatric cause of conductive hearing loss, which can lead to speech delays, and is often treated with tympanostomy tubes. Sleep apnea, often caused by enlarged tonsils and adenoids in children, can also affect speech by disrupting sleep and thus cognitive development. Tonsillectomy and adenoidectomy can help restore proper airflow and sleep quality, supporting learning and speech development. This study examines the prevalence of these procedures in children with speech delay and their relationship to demographic factors such as gender, ethnicity, and socioeconomic status.

Methods

A retrospective case-control chart review was conducted to identify pediatric patients from birth to five years diagnosed with speech delay, who underwent tympanostomy, tonsillectomy, and/or adenoidectomy from May 2020 to September 2025. Patients diagnosed with speech delay were identified using the F80.9 ICD diagnosis code for developmental disorders of speech and language. Patients who underwent these procedures were identified by their respective procedure codes: tympanostomy (69436), tonsillectomy (42825/42826), and adenoidectomy (42830/42831). Demographic information relating to gender, race, and income was also collected. Statistical analysis was done in Research Electronic Data Capture (REDCap) (Vanderbilt University, Nashville, Tennessee, United States) using chi-squared and regression analysis.

Results

Of 885 pediatric patients with speech delay, 63.2% underwent at least one of the listed surgeries, with 71.8% being male and 49.4% female (p<0.01). Regression analysis showed males were 1.84 times more likely to undergo surgery than their female counterparts (p<0.001). Sixty percent of patients who received surgery underwent more than one procedure, with tympanostomy being the most common (37.4%). Caucasians had the highest rate of procedures (38.1%; p<0.01), and most patients were from middle- and lower-income households (p<0.01).

Conclusion

Male pediatric patients with speech delay were significantly more likely to undergo tympanostomy, tonsillectomy, and/or adenoidectomy than females. Most patients underwent more than one procedure, reflecting common comorbid conditions and, therefore, the need for combined intervention. Caucasian ethnicity and middle to lower socioeconomic status were also associated with higher procedure rates.