Incidence of Revision Adenoidectomy in Children

Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA.
The Laryngoscope (Impact Factor: 2.14). 10/2011; 121(10):2128-30. DOI: 10.1002/lary.22161
Source: PubMed


Adenoidectomy is a frequently performed procedure in the pediatric population. Revision rates and indications for a second procedure in children are scarce.
Retrospective cohort study.
Patient records at a multistate pediatric healthcare system were searched for all CPT codes that included adenoidectomy in children less than 12 years of age for a 5-year period (2005-2010). A subset of patients was identified for whom the same CPT codes appeared more than once in this 5-year period. The indication, age, gender, adenoid size, and technique of adenoidectomy were recorded.
A total of 23,612 occurrences of the CPT codes were identified. The subset of patients with multiple CPT codes, indicating revision adenoidectomy, included 304 records (1.3%). Mean age at first procedure was 2.8 years (SD = 1.7 years). Mean age at second procedure was 4.7 years (SD = 1.99 years). Mean interval between procedures was 1.8 years (SD = 1.1 years).
Revision adenoidectomy occurs at a rate of 1.3%. Reasons for revision include persistence symptoms ranging from adenoiditis to recurrent otitis to obstructive sleep apnea.

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Available from: Christopher R Grindle, Jan 09, 2015
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    • "There is a roughly 0.5–3.0% incidence of adenoid regrowth requiring repeat surgery reported in the literature [2] [4] [6] [17]. The reasons for re-surgery were not different from other series. "
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    ABSTRACT: To evaluate population-based data on incidence of pediatric adenoidectomy and rate of revision surgery. A retrospective study of all adenoidectomies in children was performed in the year 2009 in all otolaryngology departments in one federal state, Thuringia, in Germany. Patients' characteristics, preoperative diagnostics and postoperative complications were analyzed. The association between baseline characteristics and the risk of re-adenoidectomy was examined using Kaplan-Meier method with univariate log-rank test, and with a multivariate Cox regression model. Population data were used to calculate age-related annual rates of adenoidectomies. 1939 adenoidectomies were performed in 2009 in Thuringia. 89% were primary cases and 11% of the children already had an adenoidectomy prior to 2009. Immediate re-surgery because of primary hemorrhage was necessary in 0.8% of the cases. Re-adenoidectomy because of recurrent symptoms was needed in 9% of patients after a median interval of 16 months. The univariate analysis showed that the factors age ≤3 years and primary surgery were significantly associated to a higher risk of surgery because of recurrent symptoms The multivariate analysis showed that primary surgery was independently associated with the risk of re-surgery (hazard ratio 1.66; 95% confidence interval 1.01-2.74). The annual adenoidectomy rate was 678/100,000 underage habitants. The incidence was highest between 2 and 4 years of age. This population based analysis is showing that adenoidectomy is performed country-wide with good results and low risk on important scale in daily routine by otorhinolaryngologists. The risk of re-adenoidectomy seems to be higher than hitherto reported by hospital-based studies.
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