- by Dr Gowher Pebbles n Pearl Pediatrics and Child Care
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- Sep 16 2017
Immediate Adenoidectomy May Not Reduce URTIs in Children
(Source: British medical Journal 2011)
Immediate adenoidectomy may not lower recurrent upper respiratory tract infections (URTIs) in children, according to the results of an open randomized trial reported in the September 6 issue of the BMJ.
Between April 2007 and October 2010 at 11 general hospitals and 2 academic centers, 111 children 1 to 6 years old who were selected for adenoidectomy because of recurrent URTIs were randomly assigned to a strategy of immediate adenoidectomy with or without myringotomy or to a strategy of initial watchful waiting. The main study endpoint was the number of URTIs per person-year, as determined during follow-up of up to 24 months. Secondary endpoints were days with URTI per person-year, episodes and days of middle ear complaints with fever, prevalence of URTIs, and health-related quality of life.
"In children selected for adenoidectomy for recurrent upper respiratory tract infections, a strategy of immediate surgery confers no clinical benefits over a strategy of initial watchful waiting," the study authors write.
"Because a common genetic liability for upper airway infections is well known, and treatment for upper respiratory infections primarily aims to prevent complications such as tonsillitis, sinusitis, and otitis media, clinicians should be aware that children presenting with a family history of upper airway infections may be more vulnerable to recurrent infections," Prof. Kvaerner writes. "Careful follow-up and a strategy of watchful waiting seem prudent in the light of this study, especially because the incidence of upper respiratory infections declines with age."
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