Intended for healthcare professionals


Adenoidectomy in children with recurrent upper respiratory infections

BMJ 2011; 343 doi: (Published 06 September 2011) Cite this as: BMJ 2011;343:d5274
  1. Kari J Kvaerner, professor and otolaryngologist
  1. k.j.kvarner{at}

Immediate surgery seems to offer no benefit over initial watchful waiting

Although recurrent upper respiratory tract infections in childhood are self limiting, with high rates of spontaneous recovery,1 they are associated with high healthcare costs and frequent visits to the doctor. Most of these infections are caused by viruses. Generally, they are associated with little morbidity but predispose children to complications such as otitis media, tonsillitis, and sinusitis, which cause further morbidity.2 About a fifth of preschool children have recurrent upper respiratory tract infections, and many of these are referred to ear, nose, and throat surgeons for upper airway surgery, including adenoidectomy.3 4

Adenoidectomy restores normal breathing through the nose if the hypertrophied adenoid obstructs the nasopharynx. It can also improve hearing in children with otitis media, but it has yet to show benefit on the occurrence of otitis media, physician visits, antibiotic prescription, or days with symptoms of upper respiratory infections in children under 2 years of age.5

In the linked study (doi:10.1136/bmj.d5154), Van den Aardweg …

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