Angelo Monroy, MD, Philomena Behar, MD, and Linda Brodsky, MD, Buffalo, NY
Revision Adenoidectomy – A Retrospective Study
BACKGROUND:
Adenoid ‘‘re-growth’’ is a poorly understood phenomenon. While parents often express concerns regarding the potential for adenoid ‘‘re-growth’’, little information exists in the literature about its incidence and causation. Purpose: To establish the incidence and possible contributing factors leading to adenoid re-growth in children. Design: Retrospective case series review.
SETTING:
Tertiary care children’s hospital.
METHODS:
The charts of 106 patients who underwent revision adenoidectomy between 1995 and 2006 were reviewed. Thirty-four patients were excluded because the primary adenoidectomy was performed elsewhere or initially only a partial adenoidectomy was performed. In the remaining 72 patients, demographic data, clinical presentation, associated medical conditions and findings at surgery were studied. Results: During the 11-year study period. 13,005 adenoidectomies or adenotonsillectomies were performed; 72/13,005 (0.55%) underwent revision adenoidectomy. The mean (S.D.) age at presentation for primary adenoidectomy was 3.682.9 and 7.694.04 years for secondary (‘‘revision’’) adenoidectomy with an average time interval of 4.3 years between surgeries. Age at initial adenoidectomy was not a significant factor in predicting revision adenoid surgery. 29/72 (40%) underwent a reflux work up including scintiscan with gastric emptying, 24 h pH probe, or laryngoscopy. 28/29 (96%) were diagnosed with reflux. At least 15/72 (21%) were reported to have symptoms consistent with adenoid re-growth which were found to be caused by tubal tonsil hyperplasia.