Clinical phenotype profile and risk factors for sinusitis and obstructive sleep apnea in children with adenoid hypertrophy.

BACKGROUND

Adenoid hypertrophy (AH) is a common childhood condition frequently associated with multiple comorbidities. However, its specific clinical phenotype and the independent risk factors for key complications, particularly in children requiring surgery, remain inadequately elucidated.

METHODS

This retrospective cohort study included 161 children undergoing surgery for AH. Demographic data, disease severity indicators, comorbidities, and laboratory results were collected. Descriptive statistics, chi-square tests, and multivariate logistic regression models were used for data analysis.

RESULTS

The median age was 91 months. Sinusitis was the most common comorbidity (64.6%), followed by allergic rhinitis (27.3%) and obstructive sleep apnea (OSA, 26.1%). Multivariate analysis identified allergic rhinitis as an independent risk factor for sinusitis (adjusted odds ratio [aOR] = 2.51, 95% confidence interval [CI]: 1.16-5.70, P = 0.017). For OSA, tonsil hypertrophy grade was the strongest independent predictor (aOR = 2.90, 95% CI: 1.57 - 5.44, P < 0.001), outweighing the effect of adenoid hypertrophy.

CONCLUSION

Children with AH requiring surgery present with a complex multimorbidity profile. Allergic rhinitis significantly increases the risk of sinusitis, while tonsil hypertrophy is the key anatomical predictor for OSA. Clinical assessment and management should concurrently address allergic status and comprehensive naso-oropharyngeal obstruction.