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Effect of adenoidectomy on respiratory function: a randomised prospective study.
P S Mattila1, S Hammarén-Malmi, A S Pelkonen
1Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki, Finland. petri.mattila@hus.fi
Archives of Disease in Childhood
|January 10, 2009
Summary
Adenoidectomy did not increase the risk of asthma or allergies in children with recurrent ear infections. However, frequent respiratory infections in early childhood are linked to bronchial hyper-reactivity.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Pulmonology
- Allergy and Immunology
Background:
- Recurrent otitis media in children is linked to an increased risk of childhood asthma.
- The role of adenoidectomy, a common childhood surgery, in the development of atopy and asthma-related respiratory changes is not well understood.
Purpose of the Study:
- To evaluate the impact of adenoidectomy on the development of atopy and respiratory function changes characteristic of asthma in children with recurrent otitis media.
Main Methods:
- A randomized controlled trial was conducted with 166 children aged 12-48 months with recurrent or persistent otitis media.
- Participants were randomized to receive tympanostomy tubes with or without adenoidectomy and followed for 3 years.
- Primary outcome was exercise-induced bronchoconstriction; secondary outcomes included bronchial inflammation (exhaled nitric oxide) and atopy (skin prick tests).
Main Results:
- Adenoidectomy did not significantly affect lung function, exercise-induced bronchoconstriction, exhaled nitric oxide, atopy development, or doctor-diagnosed asthma.
- Adenoidectomy did not prevent otitis media.
- Recurrent otitis media (≥4 episodes) in the first year was associated with abnormal exercise-induced bronchoconstriction and elevated exhaled nitric oxide, irrespective of adenoidectomy.
Conclusions:
- Adenoidectomy does not appear to promote asthma or allergies in children.
- Recurrent respiratory tract infections in early childhood are associated with an increased risk of bronchial hyper-reactivity.
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