The role of adenoids in pediatric rhinosinusitis

Objective: To evaluate adenoids' importance in pediatric rhinosinusitis as a cause of mechanical blockage or as a reservoir for pathogenic bacteria. Methods: A retrospective chart review of prospectively collected data was performed, which included 410 children under the age of 14 who underwent adenoidectomy in the study. Adenoid bacteriology was evaluated with adenoid tissue culture, and sinusitis grade and adenoid size were determined using preoperative PINS X-ray. A potential correlation between these factors was then analyzed. Results: The overall adenoid bacteria isolation rate was 79.3%. The most common bacteria were Haemophilus influenza (28.5%), Streptococcus pneumonia (21.7%), Streptococcus pyogenes (21.0%), and Staphylococcus aureus (15.6%), and bacterial, isolation rate increased significantly according to sinusitis grade (p = 0.000). This was especially true of Haemophilus influenzae and Streptococcus pneumonia, whose isolation rates increased significantly (p = 0.011, p = 0.001 each). There was no statistically significant difference in sinusitis grade or bacterial. isolation rate according to adenoid size. Conclusions: Based on these results, adenoids contain many potentially pathogenic bacteria. We suggest that in pediatric rhinosinusitis, adenoids act as a reservoir for pathogenic bacteria rather than as a barrier causing mechanical obstruction. (C) 2008 Elsevier Ireland Ltd. All rights reserved.