title: Adenoidectomy vs endoscopic sinus surgery for the treatment of pediatric sinusitis.
abstract: 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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown 26506-9200, USA.
authors.forename: H H
authors.initials: HH
authors.lastname: Ramadan
mesh_terms: 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