Abstract
Although favorable effect of adenoidectomy on otitis media with effusion (OME) has been already established by several randomized clinical trials, the mechanism how OME is improved by adenoidectomy has not yet been fully clarified. In this paper, the mechanism was discussed from the viewpoints of Eustachian tube function (ETF) and sinusitis by reviewing our clinical studies carried out over 15 years. Comparison of ETFs between children with and without adenoid hypertrophy revealed no significant differences. Passive opening pressure (POP) of the Eustachian tube (ET) showed no significant improvement immediately after adenoidectomy compared to that before surgery. Comparison of ETFs between adenoidectomized and non-adenoidectomized children revealed significant improvement only in the active ventilatory function in adenoidectomized group 6 months after surgery. Improvement of sinusitis was observed more frequently in adenoidectomized children than in non-adenoidectomized children 6 months after surgery. ETF (active ventilatory function) was significantly better in those whose sinusitis was improved by adenoidectomy than in those whose sinusitis was not improved. These results indicated that OME might be improved after adenoidectomy as the inflammatory environment in the nasopharynx is improved owing to elimination of an infectious focus.
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