Objective: To determine the efficacy of adenoidectomy in relieving symptoms of chronic sinusitis in children.
Design: Retrospective case series.
Setting: Tertiary care center.
Patients: Symptoms of chronic sinusitis were studied in 48 consecutive patients who underwent adenoidectomy or adenotonsillectomy between October 1993 and May 1995. Children with cystic fibrosis or those who underwent concurrent endoscopic sinus surgery were excluded. Patient ages ranged from 1 to 12 years. Four patients were unavailable for follow-up and did not complete the study.
Main outcome measures: Patients' charts were reviewed for the presence of preoperative symptoms, including rhinorrhea, nasal congestion, headache, postnasal drainage, cough, halitosis, and irritability. Also recorded were mouth breathing, fevers, and frequent antibiotic use. Telephone interviews with the patients' caregivers were conducted to collect information following the surgery regarding the presence of the same symptoms as well as an estimate of overall improvement. Follow-up ranged from 5 months to 2 years.
Results: The most frequently reported symptoms before surgery were rhinorrhea, nasal congestion, mouth breathing, and frequent antibiotic use (35, 37, 34, and 38 patients, respectively). These numbers decreased following surgery to 18, 20, 11, and 10 patients, respectively. The average number of symptoms experienced by each patient decreased from 5.3 to 2.9. Complete or near symptom resolution was reported in 25 (58%) of 43 patients. Some improvement was reported in another 9 patients (21%). Minimal or no improvement was reported in 9 patients (21%). To date, only 3 patients have gone on to have endoscopic sinus surgery.
Conclusion: In the majority of cases, symptoms of chronic sinusitis in children are relieved by adenoidectomy.