Outcome of adenoidectomy versus adenoidectomy with maxillary sinus wash for chronic rhinosinusitis in children.

OBJECTIVES To compare postoperative outcomes of adenoidectomy versus adenoidectomy with maxillary sinus wash as surgical treatment of chronic rhinosinusitis (CRS) in children. STUDY DESIGN A retrospective review of prospectively collected data. METHODS Children who failed to respond to medical therapy for CRS and had an adenoidectomy alone (A) or an adenoidectomy with a maxillary sinus wash (wash/A) were reviewed. Outcome was assessed at least 12 months postoperatively. RESULTS Sixty children who satisfied the inclusion criteria were reviewed. Thirty-two of the children had a sinus wash at the time of adenoidectomy. The age range was 3 to 13 years (mean, 6.3 years) and the mean computed tomography (CT) score was 6.1. The two surgical groups were comparable with regard to age, sex, presence of allergies, asthma, and smoking in the household. Twenty-eight (87.5%) of the 32 patients who underwent wash/A showed improvement of their symptoms after 12 months follow-up compared with 17 (60.7%) of 28 patients who underwent A (P = .017). Multivariable analysis using logistic regression analysis with age, sex, asthma, allergy, and CT score as covariables showed that the success of wash/A compared with adenoidectomy was higher (93% to 60%) for children with a high CT score compared to those with a lower CT score (P = .011). None of the other variables showed statistical significance. CONCLUSIONS Children with more severe sinus disease as evidenced by a high CT score had a higher success rate if a maxillary sinus wash was performed at the time of adenoidectomy. Children with a low CT score did not have that benefit.