Can Computed Tomography Score Predict Outcome of Adenoidectomy for Chronic Rhinosinusitis in Children

Abstract

Chronic adenoiditis (CA) and chronic rhinosinusitis (CRS) in children are difficult to distinguish based on symptoms alone. A computed tomography (CT) scan is one way to distinguish between the two entities. The purpose of this study was to determine whether CT scores can predict outcome of adenoidectomy. A retrospective review was performed over a 10-year period. All children who failed medical treatment had a CT scan and an adenoidectomy, which were reviewed. Children who had a CT score of ≥5 were included in the CA with concurrent CRS group, whereas those who had a CT score of <5 were included in the CA without CRS group. Two hundred thirty-three children met the aforementioned criteria. Mean age was 5.5 years and mean CT score was 6.4. The CRS group had a success rate of 43%, whereas the CA group had a 65% success rate (p = 0.0017). Those children who were asthmatic and had CRS had a success rate of 28% compared with 53% for those who had CA (p = 0.022). Making the diagnosis of CRS in children seems to be critical in determining whether, initially, an adenoidectomy alone is an appropriate treatment, specifically for those who have asthma.