Adenoidectomy vs endoscopic sinus surgery for the treatment of pediatric sinusitis.
OBJECTIVE
To compare endoscopic sinus surgery with adenoidectomy for the treatment of refractory chronic sinusitis in children.


METHODS
Prospective nonrandomized study in a pediatric otolaryngology service of a university teaching hospital.


METHODS
Sixty-six children consecutively referred to the pediatric otolaryngology service between 1994 and 1997 with computed tomographic documentation of sinusitis subsequently underwent endoscopic sinus surgery or adenoidectomy. Their ages ranged from 2 to 14 years. Sixty-one children received follow-up. Two main outcomes were documented: (1) symptom status at least 6 months after the intervention and (2) requirement of the alternate procedure or a revision procedure.


RESULTS
Twenty-four (77%) of 31 children who underwent endoscopic sinus surgery had improved symptoms, compared with 14 (47%) of 30 children who underwent adenoidectomy (odds ratio [OR], 3.9; P = .01). Multivariable analysis demonstrated that endoscopic sinus surgery was significantly better than adenoidectomy after age, sex, allergy, asthma, day care attendance, and computed tomographic stage were adjusted for (OR, 5.2; P = .03). The diagnosis of asthma also appeared to be an independent predictor of success (OR, 4.37; P = .03).


CONCLUSIONS
Endoscopic sinus surgery is better than adenoidectomy for the treatment of refractory chronic sinusitis in a select group of children.
Ramadan
H H
HH
Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown 26506-9200, USA.
D000233:Adenoidectomy; D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000150:complications; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D002908:Chronic Disease; D004724:Endoscopy; D015521:Ethmoid Sinusitis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D008297:Male; D015523:Maxillary Sinusitis / Q000601:surgery; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012086:Reoperation; D012737:Sex Factors; D012852:Sinusitis / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D015524:Sphenoid Sinusitis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome