Age and adenoid size in relation to adenoidectomy in otitis media with effusion

A previously reported study showed that adenoidectomy resolved effusions in chronic bilateral otitis media with effusion in 36 to 46 per cent of 103 children. This work includes 52 additional cases and assesses the effect of age and adenoid size in relation to adenoidectomy. Pre-operative lateral cephalometric radiographs showed the adenoid size and postnasal space airway. Surgery was allocated randomly into three groups: adenotonsillectomy, adenoidectomy, and no surgery. In addition, in all cases a unilateral myringotomy and ventilating tube insertion were performed. The ear not operated upon was assessed for clearance of the effusion at 3, 6, 9, and 12 months postoperatively. Following adenoidectomy the effusion resolved in the ear not operated upon in 31 to 45 per cent of cases assessed after 1 year. Tonsillectomy conferred no additional benefit. There was a trend for improved clearance of effusions in children more than 6 years of age, compared with those less than 6 years of age. There was also a trend for improved clearance after removal of larger adenoids from children with smaller postnasal space airways, but this was only significant for 3 months postoperatively.