According to a report published on bmj.com today, surgically removing adenoids in children does not result in them having fewer respiratory tract infections, such as sinusitis and colds.

In children, upper respiratory tract infections are very common and several are referred for ear, nose and throat (ENT) surgery. In western countries, the removal of adenoids (adenoidectomy) is one of the most frequently performed surgical procedures among children, the report explains.

“One of the main reasons adenoidectomy is performed is to reduce the incidence of upper respiratory tract infections. However, the clinical effectiveness of the procedure in children with recurrent upper respiratory tract infections is lacking,” say the researchers, led by Professor Anne Schilder from the University Medical Centre Utrecht.

A group consisting of 111 children aged between one and six years of age selected for adenoidectomy were investigated by Schilder and colleagues. Half of the children were assigned to have the operation while the other half were not initially assigned.

The study was conducted across 11 general hospitals and two academic centers in the Netherlands between April 2007 and October 2010. All children who participated in the study were followed up for 24 months after surgery.

The results indicated that each child had 7.91 episodes of upper respiratory tract infections in the adenoidectomy group in comparison to 7.84 episodes in the other group. In both groups, days of absence from school or day care, and health related quality of life were similar.

The discoveries also show, that for both groups, the frequency of upper respiratory tract infections decreased over time.

The authors conclude:

“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.”

In an additional report, Professor Kari Kvaerner from Oslo University Hospital agrees that the best approach for health professionals to treat children with recurrent upper respiratory tract infections appears to be careful follow-up and a strategy of watchful waiting.

Written by Grace Rattue