Our Summary

This research study looked at young children (under the age of 3) who had an adenoidectomy - a surgery to remove the adenoids, which are small lumps of tissue in the back of the throat. This surgery is often done to help with breathing problems during sleep, known as sleep-disordered breathing (SDB).

The researchers found out how many of these children still had symptoms of SDB after the surgery and how many needed more surgery as a result. They also looked at any complications that happened during or after the surgery, and whether any factors could predict these complications.

The study involved a review of medical records from a children’s hospital between 2008 and 2012, and included 148 patients. The median age at the time of the initial adenoidectomy was about 27.5 months, the majority of patients were boys (66.2%) and Caucasians (89.2%).

The researchers found that over half of the patients (56.5%) still had symptoms of SDB after the surgery, and over a third (34.5%) needed more surgery. The study also found that having gastroesophageal reflux disease (GERD) and large tonsil size were significant predictors of needing additional surgery in this group of young patients. There was no difference in complication rates between patients who needed more surgery and those who didn’t.

In conclusion, the researchers found that symptoms of SDB are common after adenoidectomy in children under 3, and these children often need more surgery. Medical conditions like GERD and large tonsil size may help predict the need for additional surgery.

FAQs

  1. What were the main findings of the research study on adenoidectomy in young children?
  2. What factors were identified as significant predictors of the need for additional surgery after an adenoidectomy?
  3. Was there a difference in complication rates between patients who needed more surgery after an adenoidectomy and those who didn’t?

Doctor’s Tip

One helpful tip a doctor might give a patient about adenoidectomy is to follow post-operative care instructions carefully to help promote a smooth recovery. This may include taking prescribed medications, avoiding strenuous activities, maintaining good oral hygiene, and attending follow-up appointments with your healthcare provider. Additionally, it’s important to communicate any new or worsening symptoms to your doctor promptly.

Suitable For

Therefore, young children who continue to have symptoms of SDB after adenoidectomy, especially those with GERD or large tonsil size, may be recommended for additional surgery to improve their breathing. It is important for healthcare providers to closely monitor these patients and consider further interventions if needed to ensure optimal outcomes.

Timeline

Before the adenoidectomy:

  • Patient experiences symptoms of sleep-disordered breathing, such as snoring, gasping for breath, and pauses in breathing during sleep.
  • Patient may have difficulty breathing through the nose, frequent sinus infections, and ear infections.
  • Patient may undergo a sleep study to confirm the diagnosis of SDB.
  • Patient and their family discuss treatment options with their healthcare provider, including the option of adenoidectomy.

After the adenoidectomy:

  • Patient undergoes surgery to remove the adenoids, typically done under general anesthesia.
  • Patient may experience some pain and discomfort in the throat following the surgery.
  • Patient is monitored in the recovery room before being discharged home.
  • Patient may need to follow post-operative instructions, such as avoiding strenuous activities and eating soft foods.
  • Patient may still have symptoms of SDB after the surgery, and some may require additional surgery.
  • Patient may have a follow-up appointment with their healthcare provider to monitor their recovery and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about adenoidectomy include:

  1. What are the potential risks and complications associated with adenoidectomy in young children?
  2. How likely is it that my child will still have symptoms of sleep-disordered breathing after the surgery?
  3. What factors could increase the likelihood of my child needing additional surgery after the initial adenoidectomy?
  4. How will you monitor my child’s recovery after the surgery?
  5. Are there any alternative treatment options for my child’s sleep-disordered breathing?
  6. How long is the recovery period expected to be after the surgery?
  7. What can I do to help my child have a successful recovery after the adenoidectomy?
  8. Are there any lifestyle changes or precautions that my child should take after the surgery?
  9. How often will my child need follow-up appointments to monitor their progress post-surgery?
  10. What should I do if I notice any concerning symptoms or complications after the adenoidectomy?

Reference

Authors: Thadikonda KM, Shaffer AD, Stapleton AL. Journal: Int J Pediatr Otorhinolaryngol. 2018 Mar;106:46-49. doi: 10.1016/j.ijporl.2017.12.030. Epub 2018 Jan 2. PMID: 29447890