Adenoidectomy outcomes in pediatric rhinosinusitis: a meta-analysis

International Journal of Pediatric Otorhinolaryngology
Scott E Brietzke, Matthew T Brigger

Abstract

To evaluate the currently available literature regarding the reported effectiveness of adenoidectomy alone in the management of medically refractory pediatric chronic rhinosinusitis. The MEDLINE and EMBASE databases were systematically searched for English language manuscripts reporting on effectiveness of adenoidectomy alone in management of medically refractory pediatric rhinosinusitis. Additional manuscripts were identified by manual searching. Random effects modeling was performed to produce summary estimates of adenoidectomy effectiveness. Nine studies met the inclusion criteria. Six were cohort studies (level 2b) and four were case series (level 4). Mean sample size was 46 subjects (range = 10-121) with grand mean age of 5.8 years (range 4.4-6.9 years). All studies showed that sinusitis symptoms or outcomes improved in half or more patients after adenoidectomy. Eight studies were sufficiently similar to undergo meta-analysis. The summary estimate of the proportion of patients who significantly improved after adenoidectomy was 69.3% (95% CI = 56.8-81.7%, p < 0.001). The possibility of author bias was explored as one author group contributed a large proportion of patients to the study group. Adenoidectomy reduces caregiver ...Continue Reading

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