Factors Associated with Revision Adenoidectomy

Abstract

Objective: 1) Determine if patient factors, such as indication for initial surgery, medical comorbidities, and patient age, are associated with adenoid regrowth and revision adenoidectomy. 2) Determine if surgical factors, such as surgical technique or level of surgeon’s training, are associated with adenoid regrowth and need for revision adenoidectomy. Method: Retrospective review of children less than 18 years who underwent adenoidectomy or adenotonsillectomy between 1980 and May 2009. Charts of patients with revision adenoidectomies were reviewed for sex, age at surgery, indication for surgery, training level of surgeon, surgical technique, and history of allergies, asthma or GERD. Results: Of 8472 surgical cases (54% male), 202 were revision adenoidectomies (2.4%). Children less than 2 years old at initial surgery had increased rate of revision (23.5% of revision cases compared with 4.7% of all surgical cases). Of patients with revision adenoidectomy, 31.1% had curettage and 68.9% had electrocautery or coblation adenoidectomy at initial surgery. Patients with revision adenoidectomy were 3 times more likely to have a PGY1 or 2 as surgeon in initial surgery. The revision patients were found to have a higher incidence of allergies (32%), asthma (23%), and/or GERD (16%) than the general population. Conclusion: Several risk factors were associated with revision adenoidectomy. Children 3 years and under (especially under 2 years), at initial adenoidectomy have a higher incidence of revision surgery. Other factors identified with increased need for revision adenoidectomy include: medical history of allergies, asthma and/or GERD, and level of training of surgeon.