title: Pediatric adenoid surgery in Sweden 2004-2013: Incidence, indications and concomitant surgical procedures.
abstract: OBJECTIVE
  To describe the incidence and indications of adenoid surgery and concomitantly performed ENT surgical procedures in a nationwide cohort covering several years of practice.
  
  
  METHODS
  A retrospective study based on data from the National patient registry in Sweden. All children born from 1st of January 2004 to December 31st, 2013 who underwent adenoidectomy for the first time in Sweden during 2004-2013 were included in the study. Patient characteristics (age and gender), indications for surgery and performed ENT surgery were evaluated.
  
  
  RESULTS
  40,829 children underwent adenoid surgery during the studied period. Of these, 24,537 (60%) were boys. Mean and median age at surgery in the studied population was 4 years and 3.5 years respectively for both boys and girls. The most frequently performed surgical procedure was adenotonsillar surgery 43% (n = 17,434) followed by solitary adenoid surgery 26% (n = 10,749). The most frequent registered indication was hypertrophy 60% (n = 24,422) followed by hypertrophy and otitis media 21% (n = 8425). The highest age related incidence for all types of adenoid surgery taken together was 2-4 years of age for both genders. Boys had higher incidence rates than girls for all ages and all types of surgery except at eight years of age.
  
  
  CONCLUSIONS
  The main findings were that adenoidectomy most commonly was performed together with surgery of the tonsils on the indication hypertrophy, that adenoid- and adenoid related ENT surgery were most commonly performed between 2 and 5 years of age and that the incidence in surgical rates was higher for boys than girls. There seem to be large unwarranted variations between countries regarding incidence rates and we believe that there is a need for further studies in order to establish recommendations for best practice regarding adenoid and related ENT surgeries.
authors.affiliation: Department of Otorhinolaryngology, Ryhov County Hospital, Jönköping, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Gerhardsson
authors.affiliation: Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Joacim
authors.initials: J
authors.lastname: Stalfors
authors.affiliation: Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Otorhinolaryngology, Södra Älvsborgs Hospital, Borås, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Odhagen
authors.affiliation: Department of Otorhinolaryngology, Ryhov County Hospital, Jönköping, Sweden; Futurum-The Academy for Health and Care, County Council, Jönköping, Sweden. Electronic address: ola.sunnergren@rjl.se.
authors.forename: Ola
authors.initials: O
authors.lastname: Sunnergren
mesh_terms: D000233:Adenoidectomy / Q000706:statistics & numerical data*; D000234:Adenoids / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000453:epidemiology / Q000601:surgery; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010033:Otitis Media / Q000453:epidemiology / Q000601:surgery; D014066:Palatine Tonsil / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology
keywords: Adenoidectomy; Adenoids; Epidemiology; Health services research