Adenoidectomy for Otitis Media with Mucoid Effusion

Abstract

This random controlled study was undertaken to determine the extent to which nonsurgical treatment can control otitis media with effusion (OME); and if surgical treatment is indicated, and myringotomy, removal of middle ear liquid with insertion of aeration tubes is carried out, and whether removal of the adenoids produces any beneficial effect. A preparatory two-month nonsurgical treatment consisting of measures to improve the functional state of the nose was undertaken to eliminate from the study those children (42%) who would respond to medical treatment alone. The cure rate was similar in each of the operation groups with a greater relapse rate in the nonadenoidectomy groups who required 9% more aeration tube insertions. An estimation from x-rays of the size of the adenoids, shows that the group cured without surgery has a tendency towards the smaller adenoids. The relapse rate in the nonadenoidectomy group was independent of the size of the adenoids, and the study failed to show that any benefit accrued through adenoidectomy. Accordingly, the removal of adenoids should cease to be indicated in cases of OME as a primary form of treatment.

Get full access to this article

View all access options for this article.

References

Birck

Mravec

. Myringostomy for middle ear effusions. Ann Otol Rhinol Laryngol 1976; 85 Suppl 25: 263–7.

Bluestone

Beery

. Adenoidectomy in relation to otitis media. Ann Otol Rhinol Laryngol 1976; 85 Suppl 25: 280–4.

McKee

WJE

. A controlled study of the effects of tonsillectomy and adenoidectomy in children. Br J Prev Soc Med 1963; 17: 49–69.

Mawson

Adlington

Evans

. A controlled study evaluation of adenotonsillectomy in children, II. J Laryngol Otol 1968; 82: 963–79.

Roydhouse

. A controlled study of adenotonsillectomy in children. Arch Otolaryng 1970; 92: 611–6.

Gerwat

. The structure and function of the nasopharyngeal lymphoid tissue with special reference to aetiology of secretory otitis media. J Laryngol Otol 1975; 89: 169–74.

Roydhouse

. The prevention of adenotonsillectomy in children. N Z Med J 1970; 72: 373–6.

Osborn

Roydhouse

. The tonsillitis habit. Auckland: WP Roydhouse, 1976: 13–21.

Lammi

Lovric

. Assessment of iron deficiency in children without anaemia. Med J Aust 1973; 2: 541–4.

10.

Wannamaker

. Tonsils, rheumatic fever and health delivery. N Engl J Med 1970; 282: 336–7.

11.

Brooks

. School screening for middle ear effusion. Ann Otol Rhinol Laryngol 1976; 82 Suppl 25: 223–8.