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Clinical Trial
. 2004 Sep 18;329(7467):651.
doi: 10.1136/bmj.38210.827917.7C. Epub 2004 Sep 10.

Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial

Birgit K van Staaij  1 , Emma H van den Akker, Maroeska M Rovers, Gerrit Jan Hordijk, Arno W Hoes, Anne G M Schilder
Affiliations
Clinical Trial

Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial

Birgit K van Staaij et al. BMJ. .

Abstract

Objective: To assess the effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy.

Design: Open, randomised controlled trial.

Setting: 21 general hospitals and three academic centres in the Netherlands.

Participants: 300 children aged 2-8 years requiring adenotonsillectomy.

Intervention: Adenotonsillectomy compared with watchful waiting.

Main outcome measures: Episodes of fever, throat infections, upper respiratory tract infections, and health related quality of life.

Results: During the median follow up period of 22 months, children in the adenotonsillectomy group had 2.97 episodes of fever per person year compared with 3.18 in the watchful waiting group (difference -0.21, 95% confidence interval -0.54 to 0.12), 0.56 throat infections per person year compared with 0.77 (-0.21, -0.36 to -0.06), and 5.47 upper respiratory tract infections per person year compared with 6.00 (-0.53, -0.97 to -0.08). No clinically relevant differences were found for health related quality of life. Adenotonsillectomy was more effective in children with a history of three to six throat infections than in those with none to two. 12 children had complications related to surgery.

Conclusion: Adenotonsillectomy has no major clinical benefits over watchful waiting in children with mild symptoms of throat infections or adenotonsillar hypertrophy.

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Figures

Fig 1
Fig 1
Flow of participants through trial
Fig 2
Fig 2
Health related quality of life (preschool children quality of life questionnaire; TAPQoL) six and 24 months after adenotonsillectomy or watchful waiting for children aged 2-5 years
Fig 3
Fig 3
Health related quality of life (child health questionnaire parental form) six and 24 months after adenotonsillectomy or watchful waiting
Fig 4
Fig 4
Median Brouillette's obstructive sleep apnoea scores for children after adenotonsillectomy or watchful waiting
See this image and copyright information in PMC

Comment in

References

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