Abstract

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.