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Adenoidectomy and Upper Respiratory Infections

By Rallie McAllister, MD, MPH

Thinking about having your child’s adenoids removed to reduce the number of upper respiratory infections she gets each year? It might not make much difference. That’s what researchers in the Netherlands found after studying the effects of adenoidectomy in children between the ages of one and six. The results of their study* were published online in the British Medical Journal.

Children who suffer frequent respiratory tract infections are often referred to ear, nose, and throat specialists, and many of these children end up having their adenoids surgically removed. Adenoidectomy is one of the most commonly performed surgical procedures in children in Western countries, with the goal of reducing the occurrence of upper respiratory tract infections.

But the clinical effectiveness of this surgery in children is lacking, according to the authors of the recent study. The researchers studied a group of 111 children between the ages of one and six years, all of whom were candidates for adenoidectomy, based on their frequency of upper respiratory tract infections. Half the children had their adenoids surgically removed, while the other half did not. The research was conducted in 11 hospitals and two academic centers in the Netherlands between April 2007 and October 2010.

The researchers found that the children who had adenoidectomies suffered an average of 7.91 episodes of upper respiratory tract infections, while the children who did not have their adenoids removed suffered an average of 7.84 such infections. The number of school days missed and health-related quality of life was similar in both groups. The researchers also found that the prevalence of upper respiratory tract infections declined over time in both groups.

Based on these results, there appears to be no real benefit to having your child’s adenoids removed to reduce the number of coughs, colds, sore throats, and ear infections she suffers each year. The authors of the study concluded that the best way to treat children with recurrent upper respiratory tract infections appears to be careful follow-up with a physician and a strategy of watchful waiting.

*M. T. A. van den Aardweg, C. W. B. Boonacker, M. M. Rovers, A. W. Hoes, A. G. M. Schilder. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial. BMJ, 2011; 343 (sep06 1): d5154 DOI: 10.1136/bmj.d5154

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