Can computed tomography score predict outcome of adenoidectomy for chronic rhinosinusitis in children

Chronic adenoiditis (CA) and chronic rhinosinusitis (CRS) in children are difficult to distinguish based on symptoms alone. A computed tomography (CT) scan is one way to distinguish between the two entities. The purpose of this study was to determine whether CT scores can predict outcome of adenoidectomy.

A retrospective review was performed over a 10-year period. All children who failed medical treatment had a CT scan and an adenoidectomy, which were reviewed. Children who had a CT score of ≥5 were included in the CA with concurrent CRS group, whereas those who had a CT score of <5 were included in the CA without CRS group.

Two hundred thirty-three children met the aforementioned criteria. Mean age was 5.5 years and mean CT score was 6.4. The CRS group had a success rate of 43%, whereas the CA group had a 65% success rate (p = 0.0017). Those children who were asthmatic and had CRS had a success rate of 28% compared with 53% for those who had CA (p = 0.022).

Making the diagnosis of CRS in children seems to be critical in determining whether, initially, an adenoidectomy alone is an appropriate treatment, specifically for those who have asthma.