Efficacy of Adenoidectomy in Preventing Recurrence of Otitis Media with Effusion / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Previous studies of the efficacy of adenoidectomy in otitis media with effusion have yielded conflicting results. The aim of this study was to investigate the efficacy of adenoidectomy and influences of other associated risk factors on the recurrence of otitis media with effusion (OME). SUBJECTS AND METHOD: A retrospective analysis was carried out on 441 ears of 266 patients who underwent tympanostomy tube (T-tube) insertions from January 1990 to December 2000. Patients were grouped according to the surgical procedures they underwent; T-tube insertion only, T-tube insertion and adenoidectomy and T-tube insertion and adenotonsillectomy. In addition to the type of surgical procedure, the time elapsed to the extrusion of T-tube, age, paranasal sinusitis, the nature of effusion, and adenoid size were chosen as factors affecting the recurrence of otitis media with effusion. The recurrence of OME, the reinsertion of T-tube, and the number of T-tube insertions during each patients' follow-up period were defined as the dependent variables. Statistical analyses were performed by multiple logistic regression and cumulative multiple logistic regression methods. RESULTS: A significant benefit was observed with adenoidectomy in preventing recurrence of OME (p<0.001), which was not enhanced by tonsillectomy. The effect of adenoidectomy was independent of adenoid size. Earlier extrusion of tympanostomy tubes was strongly correlated with the recurrence of otitis media with effusion (p<0.0001). OME tended to recur if the patients had younger age. CONCLUSION: Performing adenoidectomy at the time of the insertion of tympanostomy tube substantially reduces the recurrence of otitis media with effusion and the likelihood of reinsertion of T-tube.

A Study of Overactive Bladder for the Women Aged over 30 years

PURPOSE: This study was designed to provide the basic data for the development of the management program for overactive bladder by ascertaining its prevalence among Korean women aged over 30 years, and the factors related to its occurrence. MATERIALS AND METHODS: The study was performed by using self-questionnaires through the community-based cross sectional study from May to July, 2000. The subjects consisted of 2869 women, aged over 30 up to 89 years, among those who understood and responded to the questionnaires, and was residing in Seoul, Kyongki Kangwon, Chungchong, YongNam, HoNam, Cheju proinces. They also did not have known neurological problem and diabetes mellitus. The data were analyzed by Student t-test, chi2-test, and multiple logistic regression with using SAS program. RESULTS: The results were as follows ; 1. They all experienced at least one of frequency, urgency, nocturia, urge incontinence for the past one year and 52.3% of the subjects had experienced symptom at least once in 5 voidings. The highest prevalence of overactive bladder was 86.2% in the category for 70 to 89 years, 74.3% for the sixties, 45.3% for the forties, 42.5% for the thirties. In the symptoms of 1499 women among subject, 19.4% of them had nocturia, 18.2% frequency, 10.5% urgency, 9.6% urge incontinence, 9.5% frequency and urgency, 5.9% frequency and nocturia. 2. The age(OR = 1.041, 95% Cl = 1.027, 1.055) and the menopause(OR = 0.696, 95% Cl = 0.527, 0.919) were related to overactive bladder occurrence. CONCLUSIONS: The above findings indicated that about the half of the women aged over 30 years had symptoms for overactive bladder, and the prevalence was higher in old women and the women with menopause. So, the prevention and management programs for overactive bladder are required to be developed, and the primary screening programs based on community shall be developed.