Comparison between the fate of Secretory Otitis Media in patients with adenoids hypertrophy undergoing Adenoidectomy alone or with Myringotomy or with Myringotomy and Tympanostomy Tube application

Abstract

Background: Otitis Media with Effusion (OME) is characterized by middle ear fluid in the absence of acute infection symptoms (fever and otalgia). The adenoid tissue is crucial to the pathogenesis of OME. There were several options for managing OME, including auto inflation and medical treatment. Surgery was used primarily to reestablish middle ear aeration by removing negative intratympanic pressure when the effusion did not resolve naturally or after three months of unsuccessful medical treatment. Aim: This study compares the results of OME in adenoids hypertrophy patients who underwent adenoidectomy alone, adenoidectomy plus myringotomy, or adenoidectomy with insertion of a tympanostomy tube (TT). Patients and methods: A total of 150 children suffering from persistent OME brought on by enlarged adenoids were scheduled for adenoidectomy alone, myringotomy, or TT implantation were included in this study. The included children were divided randomly into three equal groups as follow Group I: 50 patients underwent adenoidectomy. Group II: 50 patients underwent adenoidectomy plus myringotomy. Group III: 50 patients underwent adenoidectomy with TT insertion (Shepard tubes). Results:The results of the tympanogram after six months of healed myringotomy were significantly improved in group III relative to group I and group II. According to age class, 18 cases <4 years old, 23 cases between 4 and 8 years old, and 21 cases >8 years old were cured, and these differences were statistically significant. Regarding residence, gender and associated tonsillectomy, there were no statistically insignificant results . Conclusion: Below the age of 4 years old, for children with problems specifically related to the adenoids, clinicians may do an adenoidectomy in addition to TT insertion, while above age of 4 years old, all options are available but adenoidectomy and TT insertion has the best results.