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Adenoidectomy does not decrease respiratory tract infections in children

Clinical Question:
Does adenoidectomy decrease infections in children with recurrent respiratory tract infections?

Bottom Line:
Adenoidectomy with or without myringotomy had no clinical benefit as compared with watchful waiting in children aged 1 year to 6 years with recurrent upper respiratory tract infection (URI). Rates of infection declined over 2 years in both groups. (LOE = 1b)

Reference:
van den Aardweg MT, Boonacker CW, Rovers MM, Hoes AW, Schilder AG. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial. BMJ 2011;343:d5154.  [PMID:21896611]

Study Design:
Randomized controlled trial (nonblinded)

Funding:
Government

Allocation:
Concealed

Setting:
Outpatient (specialty)

Synopsis:
To identify patients, these investigators sought referrals from ear, nose, and throat surgeons in 13 hospitals for patients aged 1 to 6 years whom they selected for adenoidectomy with or without myringotomy to treat recurrent URI. The 111 children were randomized, using concealed allocation, to receive no treatment or adenoidectomy with or without myringotomy. No masking occurred. URI was defined as fever with at least 2 symptoms of nasal stuffiness or mouth breathing, nasal discharge, sore throat, or cough. Over the next 2 years, there were 7.91 episodes of URI per person per year in the adenoidectomy group and 7.84 episodes in the comparison group. Days of URI and middle ear complaints with fever were similar between the groups, as was health-related quality of life. Children who had surgery had significantly more days of fever than did children in the comparison group.

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