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Wait to remove kids' infected adenoids: study

A recent study found no difference in future respiratory infections or ear problems in kids who didn't remove their adenoids early on

Reuters, Monday 21 Jan 2013

A new study urges parents not to rush into surgery when it comes to frequent cold and throat infections.

Removing the adenoids of kids who frequently get colds, sinus infections and laryngitis is more expensive and doesn't lead to better health or fewer symptoms than a "watchful waiting" approach, according to new research.

In other words, "waiting has no bad consequences," Chantal Boonacker, who led the new research at University Medical Center Utrecht in the Netherlands, told Reuters Health.

Adenoids are the tissue between the nose and back of the throat, similar to tonsils. They help fight infection in children but shrink and disappear by adulthood.


The tissue becomes enlarged in some kids, and those with chronic coughs and colds may have it removed in a procedure called adenoidectomy. The new findings suggest delaying those surgeries for kids with respiratory problems may be a smart financial and medical decision.

The research included 111 children, age one to six, who'd had an average of nine or 10 respiratory infections - including colds and sinus infections - in the past year.

Half of them were randomly chosen to have an adenoidectomy right away and the rest were assigned to a watchful waiting strategy over the next two years.

In a report released in 2011, the study team found no difference in future respiratory infections or ear problems in kids who did or didn't have immediate adenoidectomy. Of the 57 kids initially allocated to watchful waiting, 23 went on to have their adenoids removed.

Boonacker cautioned that the financial and clinical findings may not apply to children who might get their adenoids removed because of ear infections or airway obstruction, for example.

Dr Hassan Ramadan, an otolaryngologist from West Virginia University in Morgantown said that in both cases, watchful waiting is often the way to go.

"Kids should not be put through the procedure before obviously trying medical therapy, and if medical therapy fails, then you proceed with the adenoidectomy," Ramadan, who wasn't involved in the new research, told Reuters Health.


For kids with breathing problems, medical treatment would include antibiotics for infection or topical nasal steroids for allergies.

"A lot of times, those kids who have problems with frequent upper respiratory tract infections, the adenoid may contribute but it may not be the only part that's causing these infections," Ramadan said.

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