Adenoidectomy for middle ear effusion: a study of 50,000 children over 24 years.
OBJECTIVE
To compare the incidence and outcomes of myringotomy plus ventilation tube insertion (MVTI) alone and that concurrent with pharyngeal surgery (adenoidectomy, adenotonsillectomy, or tonsillectomy) at a population level.


METHODS
Observational, retrospective, population-based study using hospital administrative data.


METHODS
All hospital morbidity information was obtained for children who underwent a first MVTI procedure while less than 10 years of age in any Western Australian hospital from 1981 to 2004. Further MVTI procedures and additional pharyngeal surgery were subsequently identified for each child.


RESULTS
There were 51,373 children less than 10 years of age who underwent at least one MVTI procedure from 1981 to 2004. Twenty-nine percent underwent pharyngeal surgery at the time of first MVTI procedure, and of these, 7.4% (1,096) had pharyngeal surgery in the absence of adenoid or tonsil disease. Adenoid surgery at time of MVTI was associated with reduced odds of subsequent MVTI procedures in children with or without adenoid/tonsil disease. In more recent calendar periods, no differences in the length of hospital stay between MVTI alone and with adenoidectomy was observed, whereas procedures involving tonsils required an additional bed day per procedure and were associated with more episodes of operative and postoperative hemorrhage.


CONCLUSIONS
Having adenoidectomy or adenotonsillectomy surgery at time of first or subsequent MVTI was associated with reduced risk of further MVTI surgery. The low complication rates for adenoidectomy and short hospital stays make adjunctive adenoidectomy a potentially cost-effective first line management option for otitis media with effusion.
Kadhim
Abdul Latif
AL
Department of Paediatric Otolaryngology, Princess Margaret Hospital, Perth, Western Australia.
Spilsbury
Katrina
K
Semmens
James B
JB
Coates
Harvey L
HL
Lannigan
Francis J
FJ
D000233:Adenoidectomy / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D009225:Myringoplasty / Q000706:statistics & numerical data; D010034:Otitis Media with Effusion / Q000453:epidemiology / Q000601:surgery*; D011159:Population Surveillance; D012189:Retrospective Studies; D013997:Time Factors; D014068:Tonsillectomy / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014904:Western Australia / Q000453:epidemiology