Adenoidectomy for recurrent or chronic nasal symptoms in children

Evidence Summaries

Level of Evidence = D

There is insufficient evidence on whether adenoidectomy is effective in children with recurrent or chronic nasal symptoms.

A Cochrane review 1 included 2 studies with a total of 256 children. Only one study (n=76) included children scheduled for adenoidectomy because of recurrent or chronic nasal symptoms or middle ear disease. No beneficial effect of adenoidectomy was found; improvement in episodes of common colds, defined as a reduction in number of more than two periods of snottiness, were found in 75% versus 73% after 12 months (RD 2%, 95% CI -18% to 22%), and in 77% versus 88% after 24 months (RD -11%, 95% CI -28% to 7%) in the adenoidectomy and control group. A second study included children with recurrent acute otitis media (n = 180). As otitis media is known to be associated with nasal symptoms, the number of days with rhinitis was studied as a secondary outcome measure. At six months the mean number of days with rhinitis in children who underwent adenoidectomy was 26 (SD 23) as compared to 23 (25) days in the control group. The difference was non-significant (-4 days, 95% CI -13 to 7 days).

Comment: The quality of evidence is downgraded by study quality (more than 20% loss to follow up), by inconsistency (heterogeneity in study populations and outcomes), and by imprecise results (few patients and wide confidence intervals).

References

1. van den Aardweg MT, Schilder AG, Herkert E, Boonacker CW, Rovers MM. Adenoidectomy for recurrent or chronic nasal symptoms in children. Cochrane Database Syst Rev 2010;(1):CD008282.  [PMID:20091663]


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