H. Kubba et Bjg. Bingham, Can nasal endoscopy be used to predict residual symptoms after adenoidectomy for nasal obstruction?, INT J PED O, 58(3), 2001, pp. 223-228
Citations number
17
Categorie Soggetti
Otolaryngology
Journal title
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY
Background: the efficacy of adenoidectomy in relieving nasal symptoms has b
een questioned. Although enlarged adenoids are often blamed for nasal obstr
uction, other causes can he missed if examination is not thorough. We sugge
st that endoscopy at the time of adenoidectomy may be useful to confirm lar
ge adenoids and exclude other causes, and the findings may help predict res
idual symptoms 2 years after adenoidectomy. Method: a prospective study of
a consecutive series of children undergoing adenoidectomy for nasal obstruc
tion was performed. All underwent endoscopy with a 4-mm rigid endoscope wit
hout decongestants under GA immediately prior to adenoidectomy. Two years l
ater a postal symptom questionnaire was sent, with telephone follow up for
non-responders. The findings on endoscopy were compared with residual sympt
oms at 2 years. Results: Forty-eight children aged 2-9 (mean 4) years were
enrolled, 16 of them female. At 2 years follow up, data were available for
34 children (71%). Complete obstruction of the posterior choanae of the nos
e by adenoids was seen in 21 (62%). Additional findings (e.g. septal deviat
ion, hypertrophic mucosa on the turbinates) were present in 22 (65%). Of th
em 9 (26%) had residual nasal symptoms. Of the children with less than occl
usive adenoids, six (50%,) out of 12 had residual symptoms, compared with t
hree (14%) out of 21 with occlusive adenoids (chi (2) = 4.91, P < 0.05). Al
though residual symptoms were more common in those with additional findings
on the original endoscopy (32 vs. 17%), this did not reach statistical sig
nificance. Conclusions: residual nasal symptoms are common when children ar
e followed up in the medium term. The findings on endoscopy may predict the
success of adenoidectomy in relieving the symptoms, and may help to guide
further treatment. (C) 2001 Elsevier Science Ireland Ltd. All rights reserv
ed.