Current Otorhinolaryngology Reports

, Volume 6, Issue 1, pp 64–73 | Cite as

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

  • Alexander J. Schupper
  • Javan Nation
  • Seth Pransky
Pediatric Otolaryngology (I Bruce, Section Editor)
  • 30 Downloads
Part of the following topical collections:
  1. Topical Collection on Pediatric Otolaryngology

Abstract

Purpose of Review

Review the current state of the adenoidectomy procedure in the pediatric population with up-to-date indications for surgery, operative techniques, adverse events, non-surgical management of adenoid hypertrophy, and future directions.

Recent Findings

Adenoidectomy is indicated in children for the treatment of sleep-disordered breathing, nasal airway obstruction, recurrent acute otitis media, and chronic rhinosinusitis. A new recommendation was released in 2016, not supporting adenoidectomy for a primary indication of otitis media in children under 4 years old, including those with prior tympanostomy tubes, unless a distinct indication exists such as nasal obstruction or chronic adenoiditis. Although adenotonsillectomy is the mainstay of treatment for obstructive sleep apnea (OSA), recent studies have identified that non-obese patients with moderate OSA and small tonsils have comparable benefits with adenoidectomy alone with less complications. While conventional approaches such as indirect mirror-assisted curette and suction coagulation are still utilized, direct transnasal endoscope-assisted removal of the adenoids has proven to be a safe technique, with good short- and long-term outcomes. Novel non-surgical therapies including immunotherapy have been evaluated.

Summary

Adenoidectomy is a safe procedure in the pediatric population and leads to excellent outcomes. Adverse events are rare, and hospitalization is uncommon. Children with sleep disturbance from nasal airway obstruction, ear disease, or chronic rhinosinusitis are the best operative candidates for this procedure.

Keywords

Pediatric adenoidectomy Pediatric tonsillectomy Surgical indications Surgical complications Surgical technique 

Notes

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Alexander J. Schupper
    • 2
  • Javan Nation
    • 1
    • 2
  • Seth Pransky
    • 1
    • 2
  1. 1.Rady Children’s Hospital - San DiegoSan DiegoUSA
  2. 2.UC San Diego School of MedicineSan DiegoUSA

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