EFFICACY OF ADENOIDECTOMY IN RELIEVING SYMPTOMS OF CHRONIC SINUSITIS IN CHILDREN

Objective: To determine the efficacy of adenoidectomy in relieving sym ptoms of chronic sinusitis in children. Design: Retrospective case ser ies. Setting: Tertiary care center. Patients: Symptoms of chronic sinu sitis were studied in 48 consecutive patients who underwent adenoidect omy or adenotonsillectomy between October 1993 and May 1995. Children with cystic fibrosis or those who underwent concurrent endoscopic sinu s 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 presen ce of preoperative symptoms, including rhinorrhea, nasal congestion, h eadache, postnasal drainage, cough, halitosis, and irritability. Also recorded were mouth breathing, fevers, and frequent antibiotic use. Te lephone interviews with the patients' caregivers were conducted to col lect information following the surgery regarding the presence of the s ame 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 brea thing, and frequent antibiotic use (35, 37, 34, and 38 patients, respe ctively). 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 r esolution was reported in 25 (58%) of 43 patients. Some improvement wa s 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 adenoidectom y.