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Relation between adenoid size and otitis media with effusion.

L Skoloudik1, D Kalfert2, T Valenta1

  • 1Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.

European Annals of Otorhinolaryngology, Head and Neck Diseases
|October 7, 2018
PubMed
Summary

Adenoidectomy is effective for otitis media with effusion (OME), especially when adenoids contact the torus tubarius. Adenoid size and middle ear fluid type do not impact treatment success.

Keywords:
Adenoid sizeAdenoidectomyMyringotomyOtitis media with effusion

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Medical Research

Background:

  • Otitis media with effusion (OME) is a common pediatric condition.
  • Adenoid hypertrophy is frequently implicated in OME pathogenesis.
  • The role of adenoid size and characteristics in OME treatment outcomes requires further clarification.

Purpose of the Study:

  • To compare the efficacy of adenoidectomy for OME based on adenoid size and location.
  • To investigate the relationship between adenoid morphology and middle ear effusion characteristics.
  • To determine factors influencing adenoidectomy success in OME management.

Main Methods:

  • A prospective study involving children with OME undergoing adenoidectomy and myringotomy.
  • Stratification of treatment by adenoid size causing choanal obstruction (grade I-III) and Eustachian tube ostium obstruction (grade A-C).
  • 12-month follow-up to assess treatment outcomes.

Main Results:

  • Adenoidectomy demonstrated significantly higher efficacy when adenoids contacted the torus tubarius (grade B, C) compared to smaller, non-contacting adenoids (P<0.001).
  • Adenoid volume (P=0.146) and middle ear secretion viscosity (serous vs. mucous) did not affect adenoidectomy's efficacy.
  • Overall adenoidectomy success rate was 82% for both mucous and serous secretions.

Conclusions:

  • Adenoid contact with the torus tubarius is a critical factor for successful adenoidectomy in OME, more so than adenoid volume.
  • Middle ear fluid characteristics do not influence the effectiveness of adenoidectomy for OME.