ABSTRACT Objectives: The aim of the present study was to analyze the recovery rate of symptoms in patients with adenoid hypertrophy and investigate the role of nasal pathologies, allergy and gastroesophageal reflux (GER) as the reason of failure in patients with persistent symptoms. Patients and Methods: Patients undergoing adenoidectomy were enrolled in this study. There were 58 males and 42 females, aged between 1 - 13 years (mean ± SD: 4.9 ± 2.2 years). The parents of each child were questioned about the following symptoms; apnea, nasal obstruction, mouth breathing, snoring and nasal discharge. Presence or absence of nasal obstruction due to septal deviation and/or chonchal hypertrophy was noted. All children were evaluated for GER by upper gastrointestinal endoscopy or pH monitorization and for allergy by specific IgE analysis or skin prick test. Three months after the operation the children were re-examined and their parents were interviewed about persistent symptoms. Patients with persistent symptoms were re-evaluated with rigid endoscopy for residual adenoid vegetation. Results: Apnea was cleared in the entire group postoperatively. However, 9 patients complained of nasal obstruction, 16 patients had mouth breathing, 9 patients had snoring and 17 patients continued to have nasal discharge two months after the operation. Statistical assessment showed a significant difference for each symptom between the pre- and postoperative level (p < 0.001). In the re-examination of the patients with persistent symptoms, none of them were found to have adenoid vegetation greater than grade 1. However, 71% of these patients had nasal pathology, 50% had allergy and 50% had GER. Conclusions: Adenoidectomy alone is an effective treatment for nasal obstruction and obstructive sleep symptoms in children. Persistent obstructive symptoms are usually due to nasal pathology and allergy.
Cite this paper
S. Özmen and Ö. Özmen, "Failure Rate of Adenoidectomy and Reasons of Failure in the Short Term," International Journal of Otolaryngology and Head & Neck Surgery, Vol. 1 No. 2, 2012, pp. 14-17. doi: 10.4236/ijohns.2012.12003.
 C. D. Bluestone, “Current Indications for Tonsillectomy and Adenoidectomy,” The Annals of Otology, Rhinology & Laryngology, Vol. 101, No. 1, 1992, pp. 58-64.
 E. S. Deutsch, “Tonsillectomy and Adenoidectomy: Changing Indications,” Pediatric Clinics of North America, Vol. 43, No. 6, 1996, pp. 1319-1338.
 P. Nieminen, U. Tolonen and H. Lopponen, “Snoring and Obstructive Sleep Apnea in Children: A 6-Month Follow-Up Study,” Archives of Otolaryngology, Head & Neck Surgery, Vol. 126, No. 4, 2000, pp. 481-486.
 T. Shintani, K. Asakura and A. Kataura, “The Effect of Adenotonsillectomy in Children with OSA,” International Journal of Pediatric Otorhinolaryngology, Vol. 44, No. 1, 1998, pp. 51-58.
 M. Wolfensberger, J. A. Haury and T. Linder, “Parent Satisfaction 1 Year after Adenotonsillectomy of Their Children,” International Journal of Pediatric Otorhinolaryngology, Vol. 56, No. 4, 2000, pp. 199-205.
 L. M. De Serres, C. Derkay, K. Sie, et al., “Impact of Adenotonsillectomy on Quality of Life in Children with Obstructive Sleep Disorders,” Archives of Otolaryngology, Head & Neck Surgery, Vol. 128, No. 5, 2002, pp. 489-496.
 J. S. Suen, J. E. Arnold and L. J Brooks, “Adenotonsillectomy for Treatment of Obstructive Sleep Apnea in Children,” Archives of Otolaryngology, Head & Neck Surgery, Vol. 121, No. 5, 1995, pp. 525-530.
 R. M. Rosenfeld, “Pilot Study of Outcomes in Pediatric Rhinosinusitis,” Archives of Otolaryngology, Head & Neck Surgery, Vol. 121, No. 7, 1995, pp. 729-736.
 S. J. Vanderberg and D. G. Heatley, “Efficacy of Adenoidectomy in Relieving Symptoms of Chronic Sinusitis in Children,” Archives of Otolaryngology, Head & Neck Surgery, Vol. 123, No. 7, 1997, pp. 675-678.
 M. Modrzynski and E. Zawisza, “An Analysis of the Incidence of Adenoid Hypertrophy in Allergic Children,” International Journal of Pediatric Otorhinolaryngology, Vol. 71, No. 5, 2007, pp. 713-719.
 A. Tasker, P. W. Dettmar, M. Panetti, J. A. Koufman, J. Birchall and J. P. Pearson, “Is Gastric Reflux a Cause of Otitis Media with Effusion in Children?” The Laryngoscope, Vol. 112, No. 11, 2002, pp. 1930-1934.
 M. R. Bothwell, D. S. Parson, A. Talbot, G. J. Barbero and B. Wilder, “Outcome of Reflux Therapy on Pediatric Chronic Sinusitis,” Otolaryngology—Head and Neck Surgery, Vol. 121, No. 3, 1999, pp. 255-262.
 J. H. Cho, D. H. Lee and N. S. Lee, “Size Assessment of Adenoid and Nasopharyngeal Airway by Acoustic Rhinometry in Children,” The Journal of Laryngology & Otology, Vol. 113, No. 10, 1999, pp. 899-905
 L. Brodsky, L. Moore and J. F. Stanievich, “A Comparison of Tonsillar Size and Oropharyngeal Dimensions in Children with Obstructive Adenotonsillar Hypertrophy,” International Journal of Pediatric Otorhinolaryngology, Vol. 13, No. 2, 1987, pp. 149-156.
 M. Friedman, H. Tanyeri, M. La Rosa, et al., “Clinical Predictors of Obstructive Sleep Apnea,” The Laryngoscope, Vol. 109, No. 12, 1999, pp. 1901-1907.
 B. Joshua, G. Bahar, J. Sulkes, T. Shpitzer and E. Raveh, “Adenoidectomy: Long-Term Follow-Up,” Otolaryngology—Head and Neck Surgery, Vol. 135, No. 4, 2006, pp. 576-580. doi:10.1016/j.otohns.2006.05.027
 A. Shatz, “Indications and Outcomes of Adenoidectomy in Infancy,” The Annals of Otology, Rhinology, and Laryngology, Vol. 113, No. 10, 2004, pp. 835-838.
 D. H. Darrow and C. Siemens, “Indications for Tonsillectomy and Adenoidectomy,” The Laryngoscope, Vol. 112, Suppl. 100, 2002, pp. 6-10.
 C. Celtik, S. Okten, O. Okutan, H. Aydogdu, M. Bostancioglu, G. Ekuklu, A. Asan and M. Yazicioglu, “Investigation of Indoor Molds and Allergic Diseases in Public Primary Schools in Edirne City of Turkey,” Asian Pacific Journal of Allergy and Immunology, Vol. 29, No. 1, 2011, pp. 42-49.
 E. Kurt, S. Metintas, I. Basyigit, I. Bulut, E. Coskun, S. Dabak, et al., “Prevalence and Risk Factors of Allergies in Turkey (PARFAIT): Results of a Multicentre CrossSectional Study in Adults,” European Respiratory Journal, Vol. 33, No. 4, 2009, pp. 724-733.
 B. Keles, K. Ozturk, H. Arbag, E. Gunel and B. Ozer, “Frequency of Pharyngeal Reflux in Children With Adenoid Hyperplasia,” International Journal of Pediatric Otorhinolaryngology, Vol. 69, No. 6, 2005, pp. 1103-1107. doi:10.1016/j.ijporl.2005.02.019
 M. M. Carr, C. P. Poje, D. Ehrig and L. S. Brodsky, “Incidence of Reflux in Young Children Undergoing Adenoidectomy,” The Laryngoscope, Vol. 111, No. 12, 2001, pp. 2170-2172. doi:10.1097/00005537-200112000-00018