Our Summary

This research paper investigates repeat surgeries for the removal of adenoids (a mass of lymph tissue at the back of the throat) in children in Taiwan. The study used data from Taiwan’s National Health Insurance Research Database to identify all children under 18 who had an adenoidectomy between 2000 and 2007, and then followed their medical records for at least 5 years.

The study found that out of 10,396 children, 275 had to have the procedure again, with the average time between the first and second operation being about 3 years. Interestingly, only about 59% of these repeat surgeries occurred at the same hospital as the first procedure.

The rate of repeat surgery was highest in the second year after the first operation, followed by the third year. The study also found that certain factors increased the likelihood of needing a second surgery: being younger, being male, having the surgery at a hospital in eastern Taiwan, having the surgery because of enlarged adenoids, and having additional surgeries on the nose or for inserting a ventilation tube at the same time.

In conclusion, the rate of needing a second adenoidectomy in Taiwan was about 2.6%. Factors like being a young male, having additional nose or ventilation tube surgeries, and having the procedure at an eastern Taiwan hospital increased the risk of needing a second operation.

FAQs

  1. What percentage of children in Taiwan needed a second adenoidectomy according to the study?
  2. What factors were found to increase the likelihood of needing a second adenoidectomy in children?
  3. What was the average time between the first and second adenoidectomy according to the study?

Doctor’s Tip

One helpful tip a doctor might give to a patient about adenoidectomy is to follow post-operative care instructions carefully to minimize the risk of complications and the need for a repeat surgery. This may include avoiding strenuous activities, sticking to a soft diet, and taking prescribed medications as directed. Additionally, it is important to attend follow-up appointments with the doctor to monitor healing progress and address any concerns promptly.

Suitable For

Overall, patients who may be recommended for adenoidectomy include those who have persistent symptoms such as obstructive sleep apnea, chronic ear infections, sinusitis, nasal congestion, and recurrent tonsillitis that do not respond to other treatments. Additionally, patients with complications such as nasal airway obstruction, chronic sinusitis, and middle ear effusion may also benefit from adenoidectomy. It is important for healthcare providers to carefully evaluate each individual case and consider the potential benefits and risks of the procedure before recommending adenoidectomy to a patient.

Timeline

Before the adenoidectomy:

  • Patient experiences symptoms such as difficulty breathing, snoring, sleep apnea, recurrent ear infections, and sinus infections.
  • Patient consults with an ear, nose, and throat (ENT) specialist who recommends an adenoidectomy after a physical examination and possibly imaging tests.
  • Patient and their family discuss the risks and benefits of the procedure with the ENT specialist and decide to proceed with surgery.
  • Patient undergoes preoperative testing and preparation before the scheduled surgery date.

After the adenoidectomy:

  • Patient undergoes the adenoidectomy procedure under general anesthesia, which typically lasts about 30-45 minutes.
  • Patient is monitored in the recovery room before being discharged home the same day.
  • Patient may experience some pain, throat discomfort, and nasal congestion in the days following the surgery.
  • Patient is advised to rest, drink plenty of fluids, and avoid strenuous activity for a few days to allow for proper healing.
  • Follow-up appointments with the ENT specialist are scheduled to monitor the patient’s recovery and address any concerns or complications.
  • Patient gradually resumes normal activities as their symptoms improve and the adenoidectomy site heals.
  • In some cases, a small percentage of patients may require a repeat adenoidectomy due to persistent symptoms or complications.

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?
  2. What is the success rate of adenoidectomy in relieving symptoms such as difficulty breathing, snoring, and recurrent ear infections?
  3. How long is the recovery period after adenoidectomy and what can I expect in terms of pain and discomfort?
  4. Are there any alternative treatments or therapies that could be considered before deciding on adenoidectomy?
  5. What is the likelihood of needing a repeat surgery for adenoid removal, and what factors may increase this risk?
  6. Will the adenoidectomy procedure be performed at a specialized hospital or by a specialist in this field?
  7. How will the adenoidectomy procedure be performed, and what type of anesthesia will be used?
  8. What post-operative care and follow-up appointments will be necessary after the adenoidectomy?
  9. Are there any specific restrictions or precautions I should follow after the adenoidectomy procedure?
  10. How can I best prepare for the adenoidectomy surgery, both physically and mentally?

Reference

Authors: Lee CH, Chang WH, Ko JY, Yeh TH, Hsu WC, Kang KT. Journal: Eur Arch Otorhinolaryngol. 2017 Oct;274(10):3627-3635. doi: 10.1007/s00405-017-4655-z. Epub 2017 Jun 26. PMID: 28653270