title: Finnish adenoidectomy and tympanostomy rates in children; national variation.
abstract: OBJECTIVE
  To assess upper respiratory surgery rates in Finnish children and compare the rates of adenoidectomy and tympanostomy tubes in 2002 with the 1987 cohort.
  
  
  METHODS
  Descriptive study of national upper respiratory surgery in Finland in 1987 and 2002; adenoidectomies, tympanostomy tubes and combination of these two. Surgical rates were viewed in the light of child density and number of primary care physicians and otorhinolaryngologists.
  
  
  RESULTS
  Rates of adenoidectomy and tympanostomy tubes were highest in Western Finland and lowest in Eastern Finland (p<0.00001). Peak-age for adenoidectomy and tympanostomy tubes was in the second year of life. Surgery was most common in boys (p<0.00001). Both the numbers of otorhinolaryngologists and operations increased from 1987 to 2002; the largest surgery increase, 7.3%, was found in Western Finland.
  
  
  CONCLUSIONS
  Large national differences in rates of paediatric adenoidectomy and tympanostomy tubes in Finland propose that national guidelines have not had an impact on the selection of children for surgery.
authors.affiliation: Helsinki University Central Hospital, Department of Otorhinolaryngology, PL 220 00290 Helsinki, Finland. Johanna.haapkyla@helsinki.fi <Johanna.haapkyla@helsinki.fi>
authors.forename: Johanna
authors.initials: J
authors.lastname: Haapkylä
authors.forename: Gunnhild
authors.initials: G
authors.lastname: Karevold
authors.forename: Kari Jorunn
authors.initials: KJ
authors.lastname: Kvaerner
authors.forename: Anne
authors.initials: A
authors.lastname: Pitkäranta
mesh_terms: D000233:Adenoidectomy / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000706:statistics & numerical data*