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

ABSTRACT

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.