Adenoidectomy as an Adjuvant to Primary Tympanostomy Tube Placement

Mikals, Samantha J.; Brigger, Matthew T.

doi:10.1001/jamaoto.2013.5842

Cited by 77 publications

(45 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results are similar to those of most previous studies on this topic, most of them around 40% to 50% [10], [15], [17]–[19], [35]. If a child requires tube insertion at the age of 2–4 years, he or she are more likely to have tube re-insertions.…”

Section: Discussionsupporting

confidence: 90%

“…Many studies show that adenoidectomy is only beneficial to children of certain age groups. In three studies, Gates et al and Maw showed that adenoidectomy was beneficial in children with OME older than 4 years [11], [12], [14], and one most recent systemic review and metanalysis also concluded that adenoidectomy with primary tube insertion appears to provide a protective effect against repeated surgery in children older than 4 years [35], while Hammaren-Malmi et al demonstrated that adenoidectomy did not reduce OME in children younger than 4 years old [21]. However, Coyte et al found that adenoidectomy was beneficial to children older than 2 years old and that the benefits were more obvious among children older than 3 years old [15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Protective Effect of Adenoidectomy on Pediatric Tympanostomy Tube Re-Insertions: A Population-Based Birth Cohort Study

Wang

Chu

et al. 2014

PLoS ONE

View full text Add to dashboard Cite

ObjectivesAdenoidectomy in conjunction with tympanostomy tube insertion for treating pediatric otitis media with effusion and recurrent acute otitis media has been debated for decades. Practice differed surgeon from surgeon. This study used population-based data to determine the protective effect of adenoidectomy in preventing tympanostomy tube re-insertion and tried to provide more evidence based information for surgeons when they do decision making.Study DesignRetrospective birth cohort study.MethodsThis study used the National Health Insurance Research Database for the period 2000–2009 in Taiwan. The tube reinsertion rate and time to tube re-insertion among children who received tympanostomy tubes with or without adenoidectomy were compared. Age stratification analysis was also done to explore the effects of age.ResultsAdenoidectomy showed protective effects on preventing tube re-insertion compared to tympanostomy tubes alone in children who needed tubes for the first time (tube re-insertion rate 9% versus 5.1%, p = 0.002 and longer time to re-insertions, p = 0.01), especially those aged over 4 years when they had their first tube surgery. After controlling the effect of age, adenoidectomy reduced the rate of re-insertion by 40% compared to tympanostomy tubes alone (aHR: 0.60; 95% CI: 0.41–0.89). However, the protective effect of conjunction adenoidectomy was not obvious among children with a second tympanostomy tube insertion. Children who needed their first tube surgery at the age 2–4 years were most prone to have tube re-insertions, followed by the age group of 4–6 years.ConclusionsAdenoidectomy has protective effect in preventing tympanostomy tube re-insertions compared to tympanostomy tubes alone, especially for children older than 4 years old and who needed tubes for the first time. Nonetheless, clinicians should still weigh the pros and cons of the procedure for their pediatric patients.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

The Protective Effect of Adenoidectomy on Pediatric Tympanostomy Tube Re-Insertions: A Population-Based Birth Cohort Study

Wang

Chu

et al. 2014

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Similar results evolved from another study [62]. A recent systematic review and meta-analysis [63•] compared TT insertion alone with combined surgery with TT and adenoidectomy. Fifteen studies were included, main outcome measure was repeated surgery with TT and r-TT.…”

Section: Preventionsupporting

confidence: 76%

Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?

Granath

2017

Curr Otorhinolaryngol Rep

View full text Add to dashboard Cite

Purpose of ReviewTo survey current strategies for treatment and prevention of recurrent acute otitis media (rAOM).Recent FindingsTreatment with systemic antibiotics is required in recurrent episodes of acute otitis media. A cautious attitude is recommended due to antibiotic resistance. Antibiotics also provide effective prophylaxis for rAOM. Topical treatment with ear drops is recommended in rAOM with otorrhea from tympanostomy tubes. Pneumococcal conjugated vaccines seem to have a moderate reductive effect on overall otitis media. The effect on rAOM is still unclear. Different administrations of immunoglobulins have not been effective against rAOM. Breastfeeding had a protective effect against rAOM. A recommendation against cigarette smoke exposure as a measure to prevent otitis seems warranted. An effect for adenoidectomy in children <2 years old with rAOM has been suggested. There is a strong genetic connection with rAOM. Probiotics and nasal spray with Streptococci might offer future opportunities as prophylaxis. Too little is known about complimentary treatments to give any recommendations.SummarySystemic antibiotics are still needed as treatment against episodes of AOM in rAOM children. There are several preventive measures that can be taken to reduce the burden of AOM but they all have a small-moderate effect. Systemic antibiotics provide effective prophylaxis in rAOM, but must be used with extreme caution due to the emerging antibiotic resistance.

show abstract

“…Recurrent infections, including recurring otitis media (ROM) and adenoid hypertrophy (AH), are common indications for adenoidectomy (3). Consequently, acting on these factors could reduce the requirement for surgery.…”

mentioning

confidence: 99%