Effect of adenoidectomy in children with complex problems of rhinosinusitis and associated diseases.
OBJECTIVE
The effectiveness of adenoidectomy in the management of pediatric sinusitis is still a controversial issue. The size of the adenoid and associated diseases are the factors for consideration. The adenoid has been studied and is proved to be a probable source of infection for the paranasal sinus. The purpose of this study is to evaluate the efficacy of adenoidectomy in reducing the frequency of sinusitis in children.


METHODS
A prospective study was done in pediatric patients with rhinosinusitis admitted for adenoidectomy from January 2000 to January 2002. Pre-operative frequency of rhinosinusitis, underlying diseases and the diseases caused by the adenoid were recorded. The adenoid size was evaluated by lateral skull X-ray. The patients were followed after surgery and frequency of rhinosinusitis and associated diseases were compared with the pre-operative period.


RESULTS
There were 37 patients with mean age of 6+/-2.8 years. Mean duration for pre-operative review was 436.7 days and mean duration for post-operative follow up was 450.2 days. Almost all (92%) of the patients had obstructive sleep disorder and 88.2% had adenoid-nasopharyngeal ratio >0.7. There was a statistically significant reduction of episodes per year of rhinosinusitis and obstructive sleep disorder after surgery (P-value < 0.001 and 0.008, respectively).


CONCLUSIONS
Adenoidectomy was proved to be effective in the management of pediatric rhinosinusitis in this series. Adenoidectomy should be most beneficial as a surgical option before endoscopic sinus surgery (ESS), especially in younger children with obstructive symptoms.
Ungkanont
Kitirat
K
Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Damrongsak
Siri
S
D000233:Adenoidectomy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000150:complications / Q000601:surgery; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000601:surgery; D011446:Prospective Studies; D011859:Radiography; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D012307:Risk Factors; D012852:Sinusitis / Q000150:complications / Q000601:surgery*; D020181:Sleep Apnea, Obstructive / Q000150:complications; D014068:Tonsillectomy; D016896:Treatment Outcome