Regrowth of the adenoids after coblation adenoidectomy: cephalometric analysis

Laryngoscope. 2013 Oct;123(10):2567-72. doi: 10.1002/lary.23984. Epub 2013 Aug 5.

Abstract

Objectives/hypothesis: To analyze the prevalence of adenoid regrowth at 1 year after coblation adenoidectomy using cephalometric radiography.

Study design: Retrospective analysis.

Methods: One hundred eighty-eight children who underwent adenoidectomy from June 2006 through September 2010 were included. Demographic data, preoperative size of palatine tonsils, presence of allergic rhinitis, concurrent operation of recurrent middle ear effusion, and preoperative and postoperative Korean version of Obstructive Sleep Apnea-18 (KOSA-18) scores were analyzed. The size of the adenoids was measured three times in all the children by lateral cephalometry; preoperatively, at 1 month after adenoidectomy to observe adenoid residual; and at 1 year after surgery to observe adenoid regrowth.

Results: The adenoid regrowth at 1 year after adenoidectomy was observed in 25 children (13.3%), and the adenoid residual at 1 month after surgery was observed in 11 children (5.9%) in the cephalometry. Seven of the 11 children with residual disease (63.6%) had adenoid regrowth at 1 year. The regrowth group was significantly younger than no regrowth group, and the preoperative adenoids were larger in regrowth group than in no regrowth group. The symptoms of sleep disordered breathing recurred in two patients and they had revision adenoidectomy.

Conclusion: The regrowth rate of the adenoids at 1 year was not low. However, most of the patients were asymptomatic. The adenoid residual at 1 month contributed to regrowth at 1 year, and the risk factors of the adenoid regrowth were younger age and larger initial size of the adenoids.

Level of evidence: 2b.

Keywords: Adenoids; adenoid regrowth; adenoid residual; adenoidectomy; tonsillectomy; tonsils.

MeSH terms

  • Adenoidectomy* / methods
  • Adenoids / pathology*
  • Age Factors
  • Cephalometry
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hypertrophy
  • Male
  • Palatine Tonsil / pathology
  • Retrospective Studies
  • Rhinitis, Allergic, Perennial / epidemiology