Intervention Review

Adenoidectomy for recurrent or chronic nasal symptoms in children

  1. Maaike TA van den Aardweg1,*,
  2. Anne GM Schilder2,
  3. Ellen Herkert1,
  4. Chantal WB Boonacker3,
  5. Maroeska M Rovers2

Editorial Group: Cochrane Ear, Nose and Throat Disorders Group

Published Online: 17 MAR 2010

Assessed as up-to-date: 29 MAR 2009

DOI: 10.1002/14651858.CD008282

Database Title

Additional Information

How to Cite

van den Aardweg MTA, Schilder AGM, Herkert E, Boonacker CWB, Rovers MM. Adenoidectomy for recurrent or chronic nasal symptoms in children. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD008282. DOI: 10.1002/14651858.CD008282.

Author Information

  1. 1

    University Medical Center Utrecht, Department of Otorhinolaryngology, Utrecht, Netherlands

  2. 2

    University Medical Center Utrecht, Department of Otorhinolaryngology & Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands

  3. 3

    University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands

*Maaike TA van den Aardweg, Department of Otorhinolaryngology, University Medical Center Utrecht, Wilhelmina Children's Hospital, HP: KE.04.140.5, PO Box 85090, Utrecht, 3508 AB, Netherlands. M.T.A.vandenAardweg@umcutrecht.nl.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 17 MAR 2010

SEARCH

ARTICLE TOOLS

View Full Article (HTML) Summary (57K)Standard (225K)Full (239K)
 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Adenoidectomy, surgical removal of the adenoids, is a common ENT operation worldwide in children with recurrent or chronic nasal symptoms. A systematic review on the effectiveness of adenoidectomy in this specific group has not previously been performed.

Objectives

To assess the effectiveness of adenoidectomy versus non-surgical management in children with recurrent or chronic nasal symptoms.

Search methods

We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 30 March 2009.

Selection criteria

Randomised controlled trials comparing adenoidectomy, with or without tympanostomy tubes, versus non-surgical management or tympanostomy tubes alone in children with recurrent or chronic nasal symptoms. The primary outcome studied was the number of episodes, days per episode and per year with nasal symptoms and the proportion of children with recurrent episodes of nasal symptoms. Secondary outcomes were mean number of episodes, mean number of days per episode and per year, and proportion of children with nasal obstruction alone.

Data collection and analysis

Two authors assessed trial quality and extracted data independently.

Main results

Only one study included children scheduled for adenoidectomy because of recurrent or chronic nasal symptoms or middle ear disease. In this study no beneficial effect of adenoidectomy was found. The numbers in this study were, however, small (n = 76) and the quality of the study was moderate. The outcome was improvement in episodes of common colds. The risk differences were non-significant, being 2% (95% CI -18% to 22%) and -11% (95% CI -28% to 7%) after 12 and 24 months, respectively.

A second study included children with recurrent acute otitis media (n = 180). As otitis media is known to be associated with nasal symptoms, the number of days with rhinitis was studied as a secondary outcome measure. The risk difference was non-significant, being -4 days (95% CI -13 to 7 days).

Authors' conclusions

Current evidence regarding the effect of adenoidectomy on recurrent or chronic nasal symptoms or nasal obstruction alone is sparse, inconclusive and has a significant risk of bias.

High quality trials assessing the effectiveness of adenoidectomy in children with recurrent or chronic nasal symptoms should be initiated.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Adenoidectomy for recurrent of chronic nasal symptoms in children

Infections of the upper respiratory tract, presenting as recurrent nasal symptoms (nasal discharge with or without nasal obstruction) are very common in children. Removal of the adenoids (adenoidectomy) is a surgical procedure that is frequently performed in these children. It is thought that adenoidectomy prevents recurrence of nasal symptoms.

Our review, which includes two studies (256 children), shows that it is uncertain whether adenoidectomy is effective in children with recurrent or chronic nasal symptoms. Further high quality trials are needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

腺樣體切除 (Adenoidectomy) 用於兒童的復發性或慢性鼻症狀 (recurrent or chronic nasal symptoms in children)

腺樣體切除，即手術切除腺樣體，在全世界具有復發性或慢性鼻症狀的兒童當中，是一種常見的耳鼻喉科手術。過去還沒有關於腺樣體切除在這個特殊族群的效果的系統性回顧。

目標

評估腺樣體切除與非手術方式在兒童的復發性或慢性鼻症狀的效果

搜尋策略

我們搜尋了包括 the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE;CINAHL;Web of Science; BIOSIS Previews;Cambridge Scientific Abstracts;mRCT 以及已發表及尚未發表的試驗. 最後一次搜尋的時間在2009年３月３０日.

選擇標準

比較對於具有復發性或慢性鼻症狀的兒童，腺樣體切除不論有無併用通氣管 (tympanostomy tubes) ，跟非手術治療或是只使用通氣管的隨機對照試驗。第一結果是發作的次數，每次具有鼻部症狀的天數，一年之中具有鼻部症狀的天數以及兒童鼻子症狀反覆鼻部症狀的比率。第二結果是平均發作次數，每次發作的平均日數，每年發作的平均日數以及兒童只有鼻塞的比率。

資料收集與分析

兩位作者獨立地評估試驗的品質及擷取結果.

主要結論

只有一篇關於兒童因復發性、慢性的鼻症狀或中耳疾病接受腺樣體切除治療的文章，根據這篇文章，腺樣體切除沒有顯著的效果。然而，這篇文章的樣本數小 (76位) ，文章的品質中等，研究是以每次感冒的改善狀況為結果，在追蹤12個月及24個月後，risk difference沒有顯著差異，分別為2% (95% CI −18% to 22%) 和11% (95% CI −28% to 7%) 。 在另一篇文章收納了復發性急性中耳炎的兒童 (180位) ，因為我們已認知中耳炎跟鼻子症狀有相關性，所以這篇文章以鼻炎的天數當做第二結果，其結果risk difference沒有顯著的差異，是 −4 天 (95% CI −13 to 7 天) 。

作者結論

目前關於腺樣體切除用於復發性或慢性鼻症狀或只有鼻塞的效果的證據不足而且無法獲得結論,同時具有明顯的偏差. 還需要高品質的試驗評估腺樣體切除用於兒童的復發性或慢性鼻症狀的效果.

翻譯人

本摘要由基隆長庚醫院沈芳瑩翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

腺樣體切除用於兒童的復發性或慢性鼻症狀上吸道感染以反覆發作的鼻症狀 (流鼻涕不論有或無合併鼻塞) 在兒童當中是常見的，移除腺樣體 (腺樣體切除) 是一種常用於這些兒童的手術，一般認為腺樣體切除可以預防鼻症狀復發。我們回顧(包含兩篇文章總共256位兒童)的結果為，腺樣體切除對於兒童的復發性或慢性鼻症狀仍不確定是不是有效，其他高品質的試驗是必須的。

View Full Article (HTML) Summary (57K)Standard (225K)Full (239K)