American journal of otolaryngology · 2025
Adenoid regrowth and obesity in a longitudinal pediatric cohort.
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Arida-Moody Liliana, Habib Daniel R S, Neal Emma H, Whigham Amy S
Аннотация
OBJECTIVE: This study aims to elucidate the association between pediatric obesity and revision adenoidectomy in a cohort with longitudinal care needs.
METHODS: Data were collected via chart review from a tertiary pediatric hospital for patients who underwent adenoidectomy from January 2015 to January 2016 and had 2 years of post-operative follow-up. Demographic, surgical, and clinical data were analyzed using logistic and Cox regression models to identify factors affecting the likelihood and timing of revision adenoidectomy.
RESULTS: Of 461 patients, 115 (24.9 %) were obese at primary intervention. Secondary intervention was performed for 136 patients (29.5 %), with a median interval of 29 months between procedures. In the logistic regression, predictors of revision included younger age at primary intervention (OR = 0.844, p = 0.002), adenoidectomy over adenotonsillectomy as the initial surgery (OR = 0.3, p < 0.001), higher BMI percentile (OR = 1.008, p = 0.048), and allergic rhinitis (OR = 1.722, p = 0.039). In the Cox regression, hazard was lower with adenotonsillectomy (HR = 0.358, p < 0.001), older age at initial surgery (HR = 0.858, p = 0.001), and GERD (HR = 0.595, p = 0.05), but higher with laryngomalacia/tracheomalacia (HR = 1.909, p = 0.034). BMI percentile was not associated with revision timing in the Cox model. Model concordance was 0.694.
CONCLUSION: Odds of revision adenoidectomy in this population are increased with higher BMI percentile, younger age at primary intervention, undergoing initial adenoidectomy rather than adenotonsillectomy, and various comorbidities, with differing time-dependent effects. These findings support the potential role of obesity-related inflammation in adenoid hypertrophy and individualized surgical decision-making in pediatric patients with sleep disordered breathing.
METHODS: Data were collected via chart review from a tertiary pediatric hospital for patients who underwent adenoidectomy from January 2015 to January 2016 and had 2 years of post-operative follow-up. Demographic, surgical, and clinical data were analyzed using logistic and Cox regression models to identify factors affecting the likelihood and timing of revision adenoidectomy.
RESULTS: Of 461 patients, 115 (24.9 %) were obese at primary intervention. Secondary intervention was performed for 136 patients (29.5 %), with a median interval of 29 months between procedures. In the logistic regression, predictors of revision included younger age at primary intervention (OR = 0.844, p = 0.002), adenoidectomy over adenotonsillectomy as the initial surgery (OR = 0.3, p < 0.001), higher BMI percentile (OR = 1.008, p = 0.048), and allergic rhinitis (OR = 1.722, p = 0.039). In the Cox regression, hazard was lower with adenotonsillectomy (HR = 0.358, p < 0.001), older age at initial surgery (HR = 0.858, p = 0.001), and GERD (HR = 0.595, p = 0.05), but higher with laryngomalacia/tracheomalacia (HR = 1.909, p = 0.034). BMI percentile was not associated with revision timing in the Cox model. Model concordance was 0.694.
CONCLUSION: Odds of revision adenoidectomy in this population are increased with higher BMI percentile, younger age at primary intervention, undergoing initial adenoidectomy rather than adenotonsillectomy, and various comorbidities, with differing time-dependent effects. These findings support the potential role of obesity-related inflammation in adenoid hypertrophy and individualized surgical decision-making in pediatric patients with sleep disordered breathing.