Adenotonsillectomy (AT) improves short-term symptoms of attention deficit hyperactivity disorder (ADHD) in children; however, its long-term effects remain unclear. We aimed to verify the therapeutic long-term effects of AT in children with ADHD.
This retrospective control study included children aged <18 years who were diagnosed with ADHD and receiving ADHD medications. Participants were divided into groups depending on whether AT was performed (AT [+] or AT [-] groups) and matched 1:1 for age, sex, and year and month of diagnosis using randomized non-replacement selection.
Among patients with ADHD (n = 171,112), 3,615 underwent AT. In both groups, the number of drugs taken gradually increased before and decreased after the AT date (ATD). There was no difference in the number of drugs used before ( = 0.88) and after ATD ( = 0.06). Before ATD, the average number of outpatient visits (nOV) did not change in both groups (AT [+]: = 0.12; AT [-]: = 0.71). After ATD, the nOV decreased only in the AT (+) group ( = 0.001). However, there was no difference in the nOV between the two groups before ( = 0.47) and after ATD ( = 0.17). Before ATD, methylphenidate doses between the groups were not different ( = 0.06); however, a significant increase was noted after ATD in the AT (+) group ( < 0.001).
AT does not result in significant long-term therapeutic effects in terms of medication use and healthcare utilization in children with ADHD.

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