Does adenoidectomy have an adjuvant effect on ventilation tube insertion and thus reduce the need for re-treatment?
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.
Maw
A R
AR
Department of Otolaryngology, Bristol Royal Infirmary, UK.
Bawden
R
R
D000233:Adenoidectomy; D000234:Adenoids / Q000601:surgery*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D010033:Otitis Media / Q000601:surgery*; D010290:Parents; D012121:Respiration, Artificial; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome