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Hassan H. Ramadan, MD, MSc

Arch Otolaryngol Head Neck Surg. 1999;125:1208-1211.

Objective  To compare endoscopic sinus surgery with adenoidectomy for the treatment of refractory chronic sinusitis in children.

Study Design  Prospective nonrandomized study in a pediatric otolaryngology service of a university teaching hospital.

Patients and Methods  Sixty-six children consecutively referred to the pediatric otolaryngology service between 1994 and 1997 with computed tomographic documentation of sinusitis subsequently underwent endoscopic sinus surgery or adenoidectomy. Their ages ranged from 2 to 14 years. Sixty-one children received follow-up. Two main outcomes were documented: (1) symptom status at least 6 months after the intervention and (2) requirement of the alternate procedure or a revision procedure.

Results  Twenty-four (77%) of 31 children who underwent endoscopic sinus surgery had improved symptoms, compared with 14 (47%) of 30 children who underwent adenoidectomy (odds ratio [OR], 3.9; P = .01). Multivariable analysis demonstrated that endoscopic sinus surgery was significantly better than adenoidectomy after age, sex, allergy, asthma, day care attendance, and computed tomographic stage were adjusted for (OR, 5.2; P = .03). The diagnosis of asthma also appeared to be an independent predictor of success (OR, 4.37; P = .03).

Conclusion  Endoscopic sinus surgery is better than adenoidectomy for the treatment of refractory chronic sinusitis in a select group of children.

From the Department of Otolaryngology–Head and Neck Surgery, West Virginia University, Morgantown.

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