[Secretory otitis media: current aspects and therapeutic role of adenoidectomy]

The prognostic influence of adenoidectomy on the clinical course of secretory otitis media (S.O.M.) was evaluated in 46 children with abnormal tympanometry, i.e. a flat curve (type B tympanogram) or a middle ear pressure less than 100 mm H2O (type C tympanogram). The children were divided by randomized, blind allocation into one group of 22 subjected to myringotomy with adenoidectomy and another group of 24 subjected to myringotomy without adenoidectomy. All 46 children were followed up by impedance audiometry, pure tone audiometry and otomicroscopy 1, 3, 6 and 15 months after surgery. No significant differences were found between the two groups. Possible pathogenetic mechanisms leading to the development of S.O.M. in the presence of large adenoids are discussed.