Pulse
Why They Regrow
What causes adenoids to come back?
By Carmen Peota
Several years ago, physicians at Mayo Clinic noticed what they thought was an increasing number of children whose adenoids had grown back after they had been removed. “We were wondering if what we were seeing was true and, if so, what were the factors that were affecting this,” says Laura Orvidas, M.D., associate professor of otolaryngology at Mayo.
Orvidas and her colleagues dug into the records of more than 8,000 patients who had undergone an adenoidectomy at Mayo during the past 30 years and found that adenoidal tissue grew back in about 2 percent of the cases. They also noticed that the rate was increasing ever so slightly.
Although they can’t explain exactly why the rate has inched up incrementally with each decade, they were able to identify three factors associated with regrowth: the patient having surgery at a young age, the patient having gastroesophageal reflux disease (GERD), and the surgeon having less training.
Orvidas says younger patients are at greater risk for regrowth because surgeons are cautious when they work on them. “The smaller the person, the less room you have to work back there, and you don’t want to injure the surrounding structures,” she notes. She speculates that GERD may cause regrowth because it causes chronic inflammation in an area very close to the back of the nose. “If you don’t remove it [the tissue] all and it’s chronically attacked, it’s going to respond,” she says. And she thinks surgeons who have had less training may be more conservative than their more experienced peers and not take out enough tissue when performing the procedure. “We need to be diligent about paying attention to our younger surgeons and making sure they’re taking enough of the tissue out.”