Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial.
OBJECTIVE
To assess the effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy.


METHODS
Open, randomised controlled trial.


METHODS
21 general hospitals and three academic centres in the Netherlands.


METHODS
300 children aged 2-8 years requiring adenotonsillectomy.


METHODS
Adenotonsillectomy compared with watchful waiting.


METHODS
Episodes of fever, throat infections, upper respiratory tract infections, and health related quality of life.


RESULTS
During the median follow up period of 22 months, children in the adenotonsillectomy group had 2.97 episodes of fever per person year compared with 3.18 in the watchful waiting group (difference -0.21, 95% confidence interval -0.54 to 0.12), 0.56 throat infections per person year compared with 0.77 (-0.21, -0.36 to -0.06), and 5.47 upper respiratory tract infections per person year compared with 6.00 (-0.53, -0.97 to -0.08). No clinically relevant differences were found for health related quality of life. Adenotonsillectomy was more effective in children with a history of three to six throat infections than in those with none to two. 12 children had complications related to surgery.


CONCLUSIONS
Adenotonsillectomy has no major clinical benefits over watchful waiting in children with mild symptoms of throat infections or adenotonsillar hypertrophy.
van Staaij
Birgit K
BK
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85060, 3508 AB Utrecht, Netherlands.
van den Akker
Emma H
EH
Rovers
Maroeska M
MM
Hordijk
Gerrit Jan
GJ
Hoes
Arno W
AW
Schilder
Anne G M
AG
D000233:Adenoidectomy / Q000379:methods*; D000234:Adenoids / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005334:Fever; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy; D014066:Palatine Tonsil / Q000473:pathology*; D010608:Pharyngeal Diseases / Q000601:surgery*; D011788:Quality of Life; D012141:Respiratory Tract Infections / Q000601:surgery*; D014068:Tonsillectomy / Q000379:methods*