Efficacy of adenoidectomy in the treatment of nasal and middle ear symptoms in children with Down syndrome.
OBJECTIVE
To compare the efficacy of adenoidectomy in children with Down syndrome and control patients.


METHODS
Medical records were reviewed for preoperative symptoms, ear complaints, date and reason for adenoidectomy, and postoperative symptoms in 27 children (mean age, 6.0 years; range, 1.6-14.5 years) with Down syndrome and 53 age- and sex-matched controls who had adenoidectomy between January 1978 and September 1997. Long-term follow-up was aided by telephone interviews. Improvement in nasal and middle ear symptoms after adenoidectomy was calculated as the percentage of patients symptom-free postoperatively among those with symptoms preoperatively.


RESULTS
After adenoidectomy, more controls than patients with Down syndrome had improvement in symptoms, including nasal obstruction (86.7% versus 50.0%; P=0.005); snoring (73.2% versus 40.9%; P=0.01); mouth breathing (84.1% versus 40.9%; P<0.001); and middle ear disease (68.0% versus 23.1%; P<0.001). Patients with Down syndrome were 7.7 times (95% confidence interval, 2.3-25.3) more likely to have chronic ear drainage after adenoidectomy.


CONCLUSIONS
The results of the study suggest that the efficacy of adenoidectomy in children with Down syndrome is significantly less than that in controls and should influence surgical decision making in these children.
Price
Daniel L
DL
Mayo Medical School, Rochester, MN, USA.
Orvidas
Laura J
LJ
Weaver
Amy L
AL
Farmer
Sara A
SA
D000233:Adenoidectomy / Q000379:methods; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D010034:Otitis Media with Effusion / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012220:Rhinitis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome