Failures of adenoidectomy for chronic rhinosinusitis in children: for whom and when do they fail?

OBJECTIVES

To determine which children who are treated with adenoidectomy for chronic rhinosinusitis (CRS) will ultimately undergo endoscopic sinus surgery (ESS) and the length of time between adenoidectomy and ESS.

STUDY DESIGN

Retrospective chart review of prospectively collected data in a tertiary pediatric otolaryngology service.

METHODS

One hundred forty-three children had adenoidectomy for CRS over a 10-year period. Follow-up was available on 121 children. Sixty-one children failed the procedure. Data were available on 55 children who underwent ESS after failing adenoidectomy for the treatment of CRS. Mean time from adenoidectomy to ESS was determined. Factors such as age, allergic rhinitis, asthma, computed tomography (CT) score, and sex were evaluated for effects on this time.

RESULTS

With use of Cox regression analysis, the mean time from adenoidectomy to ESS was 24 months, ranging from 4 to 77 months. The presence of asthma (P < .04) and age less than 7 years (P < .01) were predictors of earlier failure. Allergic rhinitis (P < .3), CT score (P < .9), and sex (P < .3) showed no effect.

CONCLUSIONS

Those who fail adenoidectomy for CRS who require ESS are mainly children who are younger than 7 years of age and have asthma. They appear to require a salvage ESS at a mean of 24 months after the adenoidectomy.