Factors affecting the outcome of adenoidectomy in children treated for chronic otitis media with effusion
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Sarantis Blioskas1, Petros Karkos1, George Psillas1
11st Department of Otorhinolaryngology - Head and Neck Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi St, 54636 Thessaloniki, Greece.
Insights
Adenoidectomy is effective for chronic otitis media with effusion in children. Young age, allergy, family history, and small palatal airway size negatively impact outcomes, requiring careful consideration during treatment planning.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Allergy and Immunology
Background:
- Chronic otitis media with effusion (COME) is a common pediatric condition.
- Adenoidectomy is a primary surgical intervention for COME.
- Identifying factors influencing adenoidectomy success is crucial for optimizing treatment.
Purpose of the Study:
- To identify potential risk factors affecting the effectiveness of adenoidectomy in treating pediatric COME.
- To evaluate the influence of age, allergy, family history, and airway size on treatment outcomes.
Main Methods:
- A cohort of 96 children with COME undergoing adenoidectomy was studied.
- Data collected included medical and family history, parental smoking, breastfeeding, and preoperative palatal airway size.
- Patients were followed for two years post-surgery, with outcomes classified as complete remission, improvement, or persistence.
Main Results:
- Children's age (under or over five years) significantly impacted adenoidectomy outcomes.
- Presence of allergy, family history of otologic disease, and smaller palatal airway size were associated with poorer outcomes (p<0.05).
- Child's sex, passive smoking, breastfeeding, and prior acute otitis media infections did not significantly affect adenoidectomy efficacy.
Conclusions:
- Adenoidectomy remains a key treatment for pediatric COME.
- Preoperative identification of young age, allergy predisposition, positive family history, and small palatal airway is essential for effective treatment planning.
- These factors represent potential drawbacks that warrant close attention to improve surgical success rates.
Objective:
The aim of this cohort was to determine potential risk factors, concerning the effectiveness of adenoidectomy in the treatment of chronic otitis media with effusion in children.
Methods:
Ninety six children with chronic otitis media with effusion treated with adenoidectomy were enrolled in this study. A thorough medical history was taken, including family history of otologic disease, parental smoking habits and breast feeding history. Radiographic palatal airway size was measured preoperatively, whereas the presence of allergy was also investigated. All patients were, postoperatively, followed up for a period of two years, in three month intervals. Disease course was classified as "complete remission", "improvement" or "consistence", in every postoperative evaluation, according to strictly established criteria.
Results:
Children's age proved to be a significant factor in the postoperative outcome of adenoidectomy, as a treatment of chronic otitis media with effusion, especially when comparing patients being over and under the fifth year of age. Also, the presence of allergy, family history of otologic disease and palatal airway size, all proved to influence postoperative outcome in a statistical significant way (p<0.05). On the other hand, child's sex, passive smoking, breast feeding and previous acute otitis media infections did not seem to alter the efficacy of adenoidectomy.
Conclusion:
Adenoidectomy remains a cornerstone in the treatment of chronic otitis media with effusion in children. Results document that young age, presence of allergy predisposition, otologic family history and small palatal airway can be important drawbacks and should be intensively sought for and taken into account, during treatment planning.
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