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Adenoidectomy for secretory otitis media
1Department of Otolaryngology, Rush Medical School, Chicago, Ill.
Insights
This study found that polyethylene tubes combined with adenoidectomy did not significantly improve outcomes for secretory otitis media compared to no treatment. However, tonsillectomy and adenoidectomy alone were highly successful in treating chronic secretory otitis media.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Surgical Innovation
Background:
- Secretory otitis media (SOM) is a common pediatric condition.
- Established treatments for SOM exist, but alternative approaches are continually explored.
- Thirty years of experience with an alternate approach to SOM treatment is reviewed.
Purpose of the Study:
- To evaluate the efficacy of polyethylene tube insertion combined with adenoidectomy/adenotonsillectomy for chronic bilateral SOM.
- To assess the long-term success rate of tonsillectomy and adenoidectomy without tube insertion in children with treatment-resistant SOM.
Main Methods:
- A formal study involved 31 children with chronic bilateral SOM undergoing tonsillectomy and adenoidectomy, with one ear intubated and the other serving as a control.
- Audiometric criteria were used for assessment at 6- to 8-week follow-up.
- A retrospective review of 425 children with treatment-resistant SOM who underwent tonsillectomy and adenoidectomy without tube insertion, followed for at least 1 year.
Main Results:
- No significant difference in outcomes was found between intubated and control ears in the formal study.
- Tonsillectomy and adenoidectomy without tube insertion in 53 children resulted in successful therapy in over 90% of patients.
- Audiometry confirmed the therapeutic success rates.
Conclusions:
- Polyethylene tube insertion concurrent with adenoidectomy/adenotonsillectomy does not offer significant benefit for chronic secretory otitis media.
- Tonsillectomy and adenoidectomy alone represent a highly effective treatment for chronic, treatment-resistant secretory otitis media.
Abstract:
Thirty years of treating secretory otitis media by what is presently considered an alternate approach is discussed. Early experience with using a polyethylene tube in one ear only led to a formal study of the efficacy of polyethylene tube use when combined with adenoidectomy or adenotonsillectomy. This study included 31 children with chronic bilateral secretory otitis media treated by tonsillectomy and adenoidectomy. At the time of surgery, one ear was intubated and the other served as a control with no treatment. Using audiometric criteria, it was found that there was no significant difference between the intubated and control ears after a 6- to 8-week follow-up. Also documented is a series of 425 children suffering from chronic secretory otitis media, all of whom were resistant to prior ear, nose, and throat or pediatric treatment. Fifty-three children had tonsillectomies and adenoidectomies without tube insertion and were followed up for at least 1 year. Audiometry was used to measure the result of therapy that was successful in more than 90% of the patients.