Impact of partial and total tonsillectomy on adenoid regrowth

To compare the rates of adenoid regrowth in children who underwent total tonsillectomy and adenoidectomy (TA) versus partial intracapsular tonsillectomy and adenoidectomy (ITA).

Retrospective cohort study.

A medical database was used to retrieve the records of 5,120 children younger than 12 years of age who had an adenoidectomy in combination with a tonsil surgery between April 2008 and September 2014. Children who had symptomatic obstructive sleep apnea without a history of recurrent tonsillitis, and underwent an endoscopic adenoidectomy with a microdebrider, in addition to a traditional tonsillectomy or partial tonsillectomy with coblation, were included in the study. Adenoid regrowth was evaluated in the children who completed at least a 1-year follow-up. The sizes of adenoids were subjectively graded and reported based upon a numerical scale.

In total, 1,504 and 1,340 children met the inclusion, and were comprised of ITA and TA groups, respectively. Adenoid regrowth was seen in 98 (7.3%) children in the TA group after 1-year follow-up. Symptomatic adenoid regrowth was seen in 19 (1.4%) children in the TA group. In the ITA group, although 71 (4.7%) children had adenoid regrowth, only one (0.06%) reached grade 3 hypertrophy that could be attributed to nasal obstruction at 1-year follow-up. Comparison of the regrowth rates of both groups at the end of the 1-year follow-up period showed a statistically significant difference (P < .001).

ITA seems to be a safe procedure with a low incidence of regrowth of adenoid tissue in children with adenotonsillar hypertrophy when compared to TA.

4. Laryngoscope, 127:753-756, 2017.