Factors associated with revision adenoidectomy.
OBJECTIVE
To determine whether patient factors (eg, indication for initial surgery, medical comorbidity, or age) are associated with adenoid regrowth and subsequent need for revision adenoidectomy and whether surgical factors (eg, surgical technique or level of surgeon's training) are associated with adenoid regrowth and subsequent need for revision adenoidectomy.


METHODS
Historical cohort study.


METHODS
Tertiary care academic medical center.


METHODS
Children (≤18 years) who underwent adenoidectomy or adenotonsillectomy between 1980 and May 2009 were identified. Medical and surgical records were reviewed for sex, age at surgery, indication for surgery, training level of surgeon, surgical technique, and history of allergies, asthma, or gastroesophageal reflux disease.


RESULTS
Of 8245 surgical cases (53.8% male), 163 were revision adenoidectomies. Age at initial adenoidectomy was a significant factor for revision adenoidectomy, with younger ages associated with higher increased risk. Indication for adenoidectomy was also a significant risk factor; adjusted for age, patients with ear rather than infectious indications were about 10 times more likely to require revision. A diagnosis of gastroesophageal reflux disease was a significant risk factor (hazard ratio, 2.23; P = .002).


CONCLUSIONS
Several risk factors are associated with revision adenoidectomy: young age at initial procedure, indication for adenoidectomy, and diagnosis of gastroesophageal reflux disease. Surgical technique, level of experience of the initial surgeon, and diagnosis of asthma or allergies were not significant risk factors for revision adenoidectomy.
Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA. dearking.amy@mayo.edu
Amy C
AC
Dearking
Brian D
BD
Lahr
Admire
A
Kuchena
Laura J
LJ
Orvidas
D000233:Adenoidectomy; D000234:Adenoids / Q000473:pathology* / Q000601:surgery*; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D006984:Hypertrophy / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008297:Male; D018579:Patient Selection; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D014068:Tonsillectomy