Our Summary

This research paper is studying the effects of a medical procedure called adenoidectomy (surgical removal of adenoids) on children aged 7 to 18 who suffer from chronic rhinosinusitis (long-term inflammation of the nasal passages and sinuses). The procedure is commonly used in younger children, but there’s less information about how well it works in older kids.

The researchers looked back at medical records from 2009 to 2019 for kids in this age range who had the procedure. They didn’t include kids with certain other medical conditions (cystic fibrosis and ciliary disorders). They gathered data on other health conditions these kids had, their symptoms before and after the surgery (like a runny nose, congestion, loss of smell, and facial pain), the medications they used, and a score that measures how severe their sinus issues were.

They found 97 patients who fit their criteria, and on average, these kids were 9 years old. After getting the surgery, the patients had less severe symptoms, and lower use of nasal steroids, antihistamines, and antibiotics. None of the patients’ personal or disease characteristics were linked to having symptoms continue after surgery. A small portion of the patients (9.3%) did need additional nasal surgery.

The authors conclude that for older kids with chronic rhinosinusitis, getting an adenoidectomy might be enough to manage their symptoms and reduce their need for medication. They don’t usually need another surgery afterward. However, they note that their study only looked at a limited follow up period.

FAQs

  1. What age group was studied in this research paper about the effects of adenoidectomy?
  2. What are the potential benefits of adenoidectomy for older children suffering from chronic rhinosinusitis, as per the study?
  3. Did the study find any link between the patients’ personal or disease characteristics and the persistence of symptoms after adenoidectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about adenoidectomy is to follow post-operative care instructions carefully, including avoiding strenuous physical activity, eating soft foods, and keeping the nasal area clean. It is also important to attend follow-up appointments to ensure proper healing and address any concerns. Additionally, it is important to communicate any new or worsening symptoms to your healthcare provider.

Suitable For

Patients who are typically recommended for adenoidectomy include:

  1. Children aged 7 to 18 with chronic rhinosinusitis who have not responded well to other treatments such as medications.
  2. Patients who have enlarged adenoids that are causing symptoms such as nasal congestion, difficulty breathing, snoring, or sleep apnea.
  3. Patients who have recurrent ear infections or chronic ear fluid buildup that is believed to be caused by enlarged adenoids.
  4. Patients who have frequent sinus infections or sinusitis that is not responding to medications.
  5. Patients with chronic cough or postnasal drip that is believed to be caused by enlarged adenoids.
  6. Patients with persistent bad breath or a persistent sore throat that is believed to be caused by enlarged adenoids.

Timeline

This timeline can be broken down as follows:

  • Before adenoidectomy:
  1. Patient experiences symptoms of chronic rhinosinusitis such as a runny nose, congestion, loss of smell, and facial pain.
  2. Patient may be prescribed medications such as nasal steroids, antihistamines, and antibiotics to manage symptoms.
  3. Patient undergoes evaluation by a healthcare provider to determine if adenoidectomy is necessary.
  4. Adenoidectomy is scheduled and performed on the patient.
  • After adenoidectomy:
  1. Patient experiences relief from symptoms and a reduction in the severity of chronic rhinosinusitis symptoms.
  2. Patient’s use of medications such as nasal steroids, antihistamines, and antibiotics decreases.
  3. Follow-up appointments with healthcare provider to monitor recovery and assess the effectiveness of the surgery.
  4. Some patients may require additional nasal surgery, although this is not common in older children.
  5. Patient may continue to see improvement in symptoms over time as they recover from the surgery.

Overall, the timeline for a patient before and after adenoidectomy involves experiencing symptoms of chronic rhinosinusitis, undergoing surgery to remove adenoids, and seeing improvements in symptoms and a reduction in the need for medication following the procedure.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with adenoidectomy in older children?

  2. How long is the recovery period after adenoidectomy, and what can be done to help manage any pain or discomfort during this time?

  3. How will adenoidectomy improve my child’s symptoms of chronic rhinosinusitis, and what are the expected outcomes after the surgery?

  4. Are there any alternative treatment options for chronic rhinosinusitis that should be considered before opting for adenoidectomy?

  5. Will my child need any additional follow-up appointments or treatments after the adenoidectomy procedure?

  6. How experienced are you in performing adenoidectomy procedures on older children, and what is your success rate with this age group?

  7. Are there any lifestyle changes or precautions my child should take before or after the adenoidectomy surgery to ensure a successful outcome?

  8. Will adenoidectomy have any impact on my child’s ability to breathe, speak, or swallow normally?

  9. How will adenoidectomy affect my child’s overall quality of life, including their ability to participate in activities and school?

  10. Can you provide any references or testimonials from other patients who have undergone adenoidectomy for chronic rhinosinusitis in older children?

Reference

Authors: Mahomva C, Anne S, Roxbury C. Journal: Ann Otol Rhinol Laryngol. 2022 Aug;131(8):868-873. doi: 10.1177/00034894211045270. Epub 2021 Sep 18. PMID: 34541924