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Prevention of otitis media by adenoidectomy in children younger than 2 years

Petri S Mattila1, Veli-Pekka Joki-Erkkilä, Terhi Kilpi

  • 1Department of Otorhinolaryngology, Helsinki University Central Hospital, PO Box 220, 00029 Helsinki, Finland. petri.mattila@hus.fi

Archives of Otolaryngology--Head & Neck Surgery
|February 13, 2003
PubMed

Insights

Adenoidectomy with tympanostomy tubes did not significantly reduce otitis media in young children. Tympanostomy tube insertion alone appears equally effective for preventing middle ear infections in children under two.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Disease Research
  • Surgical Intervention Efficacy

Background:

  • Recurrent otitis media is common in children under two.
  • Tympanostomy tubes are a standard treatment for recurrent otitis media.
  • The role of adenoidectomy in conjunction with tympanostomy for otitis media prevention is debated.

Purpose of the Study:

  • To evaluate the efficacy of adenoidectomy combined with tympanostomy compared to tympanostomy alone.
  • To determine if this surgical combination prevents otitis media in children younger than two years.
  • To analyze the impact on the rate of acute otitis media episodes.

Main Methods:

  • Prospective randomized and nonrandomized trial design.
  • Inclusion of 306 children aged 1-2 years with recurrent otitis media.
  • Comparison of tympanostomy with and without adenoidectomy, followed for a mean of 7 months.

Main Results:

  • Adenoidectomy showed a modest, non-significant reduction in otitis media episodes (19-25%).
  • A significant reduction in pneumococcal otitis media was observed in the randomized adenoidectomy group (58%).
  • Confidence intervals indicate considerable uncertainty in the overall effect.

Conclusions:

  • Concurrent adenoidectomy with tympanostomy offers no major advantage over tympanostomy alone for preventing otitis media in children under two.
  • The findings suggest that tympanostomy tube insertion is the primary driver of benefit.
  • Further research may be needed to clarify specific subgroups who might benefit from adenoidectomy.
Abstract

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