The effectiveness of adenoidectomy in the treatment of glue ear: a randomized controlled trial

One hundred children with glue ear, in whom surgical treatment was indicated, were randomly allocated to 1 of 4 treatment groups. Children in 2 of the groups underwent adenoidectomy plus various combinations of ear operations while in the other 2 groups surgery was confined to the ears. The effect of adenoidectomy was assessed 6 weeks, 6 months and 1 year after surgery by means of audiometry, impedance tympanometry and parental opinion. Improvements in hearing were greater in those children who underwent an adenoidectomy than in those who did not (4.0 dB at 6 weeks; 2.4 dB at 6 months; 0.7 dB at 1 year). However, these differences are of little clinical significance and were only statistically significant (P less than 0.05) 6 weeks after surgery. Middle ear function, measured by tympanometry, revealed a similar pattern of response to treatment. Despite this, 6 months after surgery a higher proportion of parents were satisfied with their child's condition if an adenoidectomy had been performed. Possible explanations of this discrepancy between clinical and parental assessments of outcome are discussed.