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Adenoidectomy may decrease the need for a third set of tympanostomy tubes in children.

Sarah Hancock1, Paul Allen2, Angel'Niqua Dixon1

  • 1University of Rochester School of Medicine and Dentistry, Rochester, NY 601 Elmwood Avenue, Rochester, NY, 14642, United States.

International Journal of Pediatric Otorhinolaryngology
|April 21, 2022
PubMed
Summary
This summary is machine-generated.

Removing adenoids during a second ear tube insertion in children under 4 significantly reduces the need for a third set of tubes, lowering future interventions.

Keywords:
AdenoidectomyEar tubeOtitis mediaPediatricTympanostomy

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Pediatric Otitis Media Management

Background:

  • Recurrent otitis media with effusion often necessitates multiple tympanostomy tube insertions.
  • The role of adenoids in persistent or recurrent otitis media requiring repeat tympanostomy tube placement is debated.
  • Adenoidectomy is a common procedure, but its impact on subsequent tympanostomy tube needs is not fully elucidated.

Purpose of the Study:

  • To investigate the association between adenoid removal (adenoidectomy) versus retention during second tympanostomy tube placement and the subsequent need for a third set of ear tubes in pediatric patients.
  • To evaluate this association specifically in children younger than 4 years old.

Main Methods:

  • Retrospective case series analysis of 136 pediatric subjects undergoing second tympanostomy tube insertion between January 2017 and September 2019.
  • Stratification into two groups: those who had adenoids removed (TT+A) and those who retained them (TT-A) at the time of the second tube placement.
  • Primary outcome measure was the incidence of requiring a third set of tympanostomy tubes, with a subgroup analysis for children under 4 years.

Main Results:

  • In children under 4 years (n=99), the incidence of needing a third set of tubes was significantly lower in the adenoidectomy group (12.8%) compared to the adenoid retention group (44.2%) (p=0.0008).
  • The odds ratio for needing a third tube was 0.18 (95% CI 0.067-0.51) in the adenoidectomy group.
  • The number needed to treat with adenoidectomy to prevent one additional need for a third set of tubes was 3.2.

Conclusions:

  • Adenoidectomy performed concurrently with second tympanostomy tube insertion in children under 4 years old is associated with a reduced likelihood of requiring a subsequent third set of ear tubes.
  • This finding suggests that adenoidectomy may be a beneficial intervention in this specific pediatric population to decrease the need for further otological procedures.
  • The results support considering adenoidectomy in younger children undergoing repeat tympanostomy tube placement for recurrent otitis media.