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Does adenoidectomy have an adjuvant effect on ventilation tube insertion and thus reduce the need for re-treatment?
Insights
Children with otitis media with effusion needing ventilation tubes may benefit from adenoid removal. Combining adenoidectomy with tube insertion reduced reinsertion rates over five years, suggesting potential cost-effectiveness.
Area of Science:
- Pediatric Otolaryngology
- Otorhinolaryngology
Background:
- Otitis media with effusion (OME) is common in children.
- Ventilation tube insertion is a standard treatment for persistent OME.
- Adenoidectomy is sometimes performed concurrently with ventilation tube insertion.
Purpose of the Study:
- To compare the reinsertion rates of ventilation tubes in children with OME treated with or without concurrent adenoidectomy.
- To evaluate the long-term efficacy and potential cost-effectiveness of combined adenoidectomy and tube insertion for OME.
Main Methods:
- A 5-year follow-up study of 222 children with bilateral OME.
- One ear received a ventilation tube; reinsertion was performed if OME persisted.
- Comparison between 139 children who underwent adenoidectomy plus tube insertion and 83 children who received tube insertion alone.
Main Results:
- In year 1, 91% of the combined group required one tube vs. 62% with tube alone.
- By year 5, 66% of the combined group required one tube vs. 32.5% with tube alone.
- Tube reinsertion showed a relationship with age and parental smoking.
Conclusions:
- Combined adenoidectomy and ventilation tube insertion may reduce the need for tube reinsertion in children with OME.
- This combined approach may be more cost-effective than tube insertion alone, especially as adenoidectomy becomes more established as a day case procedure.
Abstract:
Two hundred and twenty-two children with bilateral otitis media with effusion were followed for 5 years. A ventilation tube was inserted into one ear only and reinserted if the condition had not resolved. The need for reinsertion in 139 children in whom the adenoids were also removed was compared with the 83 children treated by tube insertion alone. In the combined group in year 1, 91% required one tube compared with 62% treated with only a tube. By year 5, 66% of the combined group required one tube compared with 32.5% in those without adenoidectomy. There was some relationship between tube reinsertion and age, and also with parental smoking. It is possible that the combination of adenoidectomy with tube insertion may prove more cost-effective than tube insertion in selected cases alone. In addition, once adenoidectomy becomes more established as a day case procedure, the cost benefit will be more advantageous in those children treated with adenoidectomy and a tube compared with those treated with only a tube.