A Case-Control Study of Repeated Adenoidectomy in Children

OBJECTIVES To determine the rate of repeated adenoidectomy in children and examine the risk factors associated with this condition. DESIGN A retrospective nested case-control study was performed. All cases of adenoidectomy performed at a single pediatric institution between 1990 and 2010 were examined. A total of 168 children who had undergone a repeated adenoidectomy were identified. A 1:1 matched case-control study was performed. The data were analyzed using a conditional logistic analysis. SETTING Single tertiary pediatric institution. PATIENTS Children aged 0 to 18 years having undergone at least 1 adenoidectomy. MAIN OUTCOME MEASURES Risk factors associated with repeated adenoidectomy. RESULTS A total of 10 948 adenoidectomies were performed in the study period. The rate of repeated adenoidectomy was 1.5% (168 cases). The mean age at first adenoidectomy was significantly lower in the repeated adenoidectomy group (P < .001), and children younger than 5 years at the time of adenoidectomy were 2.5 times more likely to require a repeated procedure. The case-control study identified a strong association between adenoidectomy without tonsillectomy and repeated adenoidectomy, with children who had undergone a repeated adenoidectomy having a 3.68-times higher odds (95% CI, 2.10-6.45) of having an adenoidectomy alone. CONCLUSIONS Age younger than 5 years and adenoidectomy without tonsillectomy were identified as important risk factors for repeated adenoidectomy in children. Parents should be made aware of the increased risk of adenoid regrowth if surgery is performed at a young age. Children undergoing adenoidectomy alone should be followed up carefully to monitor for symptom recurrence.