Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial

To assess the effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy. Open, randomised controlled trial. 21 general hospitals and three academic centres in the Netherlands. 300 children aged 2-8 years requiring adenotonsillectomy. Adenot...

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Bibliographic Details
Published in:Clinical otolaryngology 2005-02, Vol.30 (1), p.60-63
Main Authors: van Staaji, Birgit K, van den Akker, Emma H, Rovers, Maroeska M, Hordijk, Gerrit Jan, Hoes, Arno W, Schilder, Anne G M
Format: Article
Language:English
Subjects:
Adenoidectomy - methods
Adenoids - pathology
Child
Child, Preschool
Female
Fever - epidemiology
Follow-Up Studies
Humans
Hypertrophy
Male
Palatine Tonsil - pathology
Pharyngitis - etiology
Postoperative Complications - epidemiology
Quality of Life
Respiratory Tract Infections - complications
Tonsillectomy - methods
Tonsillitis - complications
Tonsillitis - surgery
Treatment Outcome
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Summary:To assess the effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy. Open, randomised controlled trial. 21 general hospitals and three academic centres in the Netherlands. 300 children aged 2-8 years requiring adenotonsillectomy. Adenotonsillectomy compared with watchful waiting. Episodes of fever, throat infections, upper respiratory tract infections, and health related quality of life. During the median follow up period of 22 months, children in the adenotonsillectomy group had 2.97 episodes of fever per person year compared with 3.18 in the watchful waiting group (difference -0.21%, 95% confidence interval -0.54 to 0.12), 0.56 throat infections per year compared with 0.77 (-0.21, -0.36 to -0.06), and 5.47 upper respiratory tract infections per person year compared with 6.00 (-0.53, -0.97 to -0.08). No clinically relevant differences were found for health related quality of life. Adenotonsillectomy was more effective in children with a history of three to six throat infections than in those with none or two. 12 children had surgery related complications. Adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy has no major clinical benefits over watchful waiting.
ISSN:1749-4478
1749-4486
DOI:10.1111/j.1365-2273.2005.00980.x