Impact of Adenotonsillectomy in Children Suffering From Recurrent Upper Respiratory Tract Infections.

Adenotonsillectomy is the most commonly performed surgery in children; in most cases, recurrent upper respiratory tract infections (URTIs) are the indication of surgery. This study aimed to investigate the effectiveness of adenotonsillectomy in children with URTIs in a tertiary level hospital in Bangladesh. This prospective observational study was done in the Department of Otolaryngology-Head and Neck Surgery of Chittagong Medical College Hospital (CMCH), Chattogram, Bangladesh from February 2023 to march 2024. Eighty (82) children with a diagnosis of recurrent URTIs who had adenotonsillectomy were analyzed regarding fever, throat pain, and cough. Data were recorded from each patient before surgery and 2 weeks, 1 month and 3 months after surgery. Pain was assessed by Visual Analogue Scale (VAS) and cough severity was assessed by Cough Symptoms Score (CSS). The age ranged between 4.0-14.0 years with a mean age of 8.2±2.4 years and 61.0% were female. At 3 months, pain intensity reduced in 42(51.2%) patients from baseline and remains unchanged in 40(48.8%) patients. Before surgery, 17.4% of the patients reported frequent daytime coughing which did not interfere with daytime activities. Two weeks, one month and 3 months after surgery, 4.9%, 4.9% and 7.3% of the patients reported frequent daytime coughing, respectively. Before surgery, most (64.6%) of the patients reported having night-time cough on waking only. Two (2) weeks, 1 month and 3 months after surgery, 29.3%, 20.7% and 35.4% of the patients reported night-time cough on waking only, respectively. Preoperative mean±SD temperature was 38.4±0.4°C. At 2 weeks, 1 month and 3 months after surgery, temperature reduced to 38.1±0.3°C, 37.9±0.4°C and 37.7±0.6°C, respectively (p<0.001). Adenotonsillectomy is effective in reduction of throat pain, cough severity and fever. One in every two children with recurrent URTIs reported symptomatic improvement following adenotonsillectomy.