title: Tympanostomy with and without adenoidectomy for the prevention of recurrences of acute otitis media: a randomized controlled trial.
abstract: BACKGROUND
  The prevention of otitis media, particularly among infants, remains a controversial issue. We evaluated the efficacy of insertion of tympanostomy tubes with and without adenoidectomy for preventing recurrent acute otitis media (AOM) in young children.
  
  
  METHODS
  We randomly assigned 300 children aged 10 months to 2 years who had recurrent AOM to groups receiving tympanostomy tubes (Tymp) (n = 100), tympanostomy tubes with adenoidectomy (TympAde) (n = 100) or neither (Contr) (n = 100). All the children were followed up for 12 months.
  
  
  RESULTS
  The primary outcome was intervention failure (2 AOM episodes in 2 months, 3 in 6 months or persistent effusion lasting for 2 months). Intervention failed in 21% of cases (21/100) in the Tymp group, 16% (16/100) in the TympAde group and 34% (34/100) in the Contr group. The absolute differences were -13% [95% confidence interval (CI) -25% to -1%, P = 0.04] between the Tymp and Contr groups and -18% (95% CI -30 to -6%, P =0.004) between the TympAde and Contr groups.
  
  
  CONCLUSIONS
  Insertion of tympanostomy tubes alone or with adenoidectomy was effective in preventing recurrent AOM episodes in children younger than 2 years of age.
authors.affiliation: Department of Otolaryngology, University of Oulu, Oulu, Finland. tiia.kujala@oulu.fi
authors.forename: Tiia
authors.initials: T
authors.lastname: Kujala
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Alho
authors.forename: Jukka
authors.initials: J
authors.lastname: Luotonen
authors.forename: Aila
authors.initials: A
authors.lastname: Kristo
authors.forename: Matti
authors.initials: M
authors.lastname: Uhari
authors.forename: Marjo
authors.initials: M
authors.lastname: Renko
authors.forename: Tero
authors.initials: T
authors.lastname: Kontiokari
authors.forename: Tytti
authors.initials: T
authors.lastname: Pokka
authors.forename: Petri
authors.initials: P
authors.lastname: Koivunen
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods*; D010033:Otitis Media / Q000517:prevention & control* / Q000601:surgery*; D055502:Secondary Prevention; D016896:Treatment Outcome