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Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised

M T A van den Aardweg1, C W B Boonacker, M M Rovers

  • 1Department of Otorhinolaryngology, University Medical Centre Utrecht, Netherlands.

BMJ (Clinical Research Ed.)
|September 8, 2011
PubMed

Insights

Adenoidectomy offers no clinical benefit for children with recurrent upper respiratory tract infections compared to watchful waiting. Immediate surgery did not reduce infection rates and led to more fever days.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Clinical Trials

Background:

  • Recurrent upper respiratory tract infections (URTIs) are common in children.
  • Adenoidectomy is a frequent surgical intervention for these conditions.
  • Evidence on its comparative effectiveness is crucial.

Purpose of the Study:

  • To evaluate the clinical effectiveness of adenoidectomy versus watchful waiting for recurrent URTIs in children.
  • To compare infection rates, symptom duration, and quality of life between the two strategies.

Main Methods:

  • An open randomized controlled trial was conducted across 11 general and 2 academic hospitals.
  • 111 children aged 1-6 with recurrent URTIs were randomized to immediate adenoidectomy or watchful waiting.
  • Primary outcome was the number of URTIs per person-year over 24 months.

Main Results:

  • No significant difference in the incidence of URTIs per person-year between adenoidectomy (7.91) and watchful waiting (7.84) groups.
  • Similar outcomes observed for days with URTIs, middle ear complaints, and health-related quality of life.
  • Adenoidectomy group experienced more days with fever; two surgical complications occurred.

Conclusions:

  • Immediate adenoidectomy provides no additional clinical benefit over watchful waiting for children with recurrent URTIs.
  • Watchful waiting is a viable alternative strategy, avoiding surgical risks.
  • Further research may explore specific subgroups benefiting from adenoidectomy.
Abstract

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