Evaluation of Children with Chronic Rhinosinusitis after Adenotonsillectomy

Introduction: Chronic rhinosinusitis (CRS), defined as an inflammatory process involving the paranasal sinuses that continues for at least three months, is a major cause of morbidity in the pediatric population and a difficult entity to treat with a poorly defined pathophysiology. The cornerstone of treatment for children with CRS remains aggressive antibiotic therapy, but many patients fail to improve even after extended courses of broad-spectrum oral antibiotics.  However, good treatment results with adenoidectomy alone have been reported in pediatric patients with CRS. The purpose of this study was to evaluate the effect of adenotonsillectomy on chronic rhinosinusitis in children.   Materials and Methods: In this clinical trial the study population was ۴۰ children under ۱۴ years old who had been selected for adenotonsillectomy. Prior to the procedure, a Waters’ view radiograph was performed on individuals that suffered from CRS and displayed symptoms such as rhinorrhea, halitosis, and chronic cough. Only patients with bilateral clouding of the maxillary sinuses were enrolled in study. A further radiograph was performed on the ۲۸th day following the procedure and the outcome of the treatment evaluated. Results: Of the ۴۰ patients under ۱۴ years old who were evaluated, ۲۲ (۵۵%) were female and ۱۸ (۴۵%) were male. The mean age of the patients was ۷.۲۲ years while the oldest was ۱۴ and the youngest was ۴ years old.  Nasal congestion, rhinorrhea, post nasal drip, and chronic cough were present in all of the patients. Following the adenotonsillectomy, these symptoms were significantly reduced and were present in only ۱۵.۵%, ۰%, ۲۰%, and ۲۰% of the patients, respectively. Multivariate analyses were performed using McNemar’s test. Conclusion: According to the results of this study, where ۷۲.۵% of patients showed a complete recovery following treatment, an adenotonsillectomy can be considered as a treatment modality for CRS.

Keywords:

Adenoid , Adenoidectomy , Palatine tonsil , Tonsillectomy