Effectiveness of Surgical Approach of Insertion Ventilation Tubes (Tympanostomy) and Adenoidectomy in Comparison with Non-Surgical Approach (Watchful Waiting Approach) in Children at the Age between 1 and 6 and Who Suffer from Otitis Media with Effusion (OME) in 12-Month Period of Observation-The Retrospective Analysis.

Magdalena Beata Skarzynska,Milaine Dominici Sanfis,Elżbieta Gos,Natalia Czajka,Piotr Henryk Skarzynski

doi:10.3390/ijerph182312502

Abstract

(1) Background: Otitis media with effusion (OME) is one of the most common diseases in childhood. The objective was to assess clinically the effectiveness of the surgical approach (tube insertion with adenoidectomy) in comparison with the non-surgical approach (watchful waiting) during a 12-month observation period. (2) Methods: This study was retrospective and obtained approval from the bioethics committee. The criteria of inclusion in the first group (surgical approach) were: (1) a diagnosis of chronic otitis media with effusion in children aged between 1 and 6 years; (2) their medical history showed that they had undergone adenoidectomy and tympanostomy with the insertion of ventilation tubes (VTs). The criteria for inclusion in the second group (non-surgery) were similar to the first group except that their medical history showed they had not undergone adenoidectomy or tympanostomy with the insertion of VTs. There were 422 children included in the surgical group and 50 children in the non-surgical group, and the period of observation was 12 months. (3) Results: For the entire surgical group, the number of healthy days ranged from 20 to 365, with a mean of 328.0 days (SD = 91.4).In the non-surgical group, the number of healthy days ranged from 13 to 365, with a mean of 169.2 days (SD = 127.3). The difference in the number of healthy days was statistically significant (p < 0.001). The certainty of treatment in the first group was higher than in the second group, and the number of days without recurrence was significantly higher than in the second group. In the first group, there were 71 recurrences from 422 children (16.8%), and, in the second subgroup, there were 40 recurrences of acute otitis media (AOM) from 50 children (80%). The RR was 0.21. (4) Conclusions: The surgical approach in children aged 1–6 years who have been diagnosed with otitis media with effusion is reasonable and beneficial for the child.

Highlights

Otitis media with effusion (OME) is one of the most common diseases in childhood.The condition refers to an accumulation of fluid in the cavity of the middle ear behindInt
ventilation tubes (VTs) are recommended for children with persistent OME and with documented hearing difficulties following a 3-month watchful waiting period [25,27]
There were 422 children who were diagnosed with acute otitis media

Summary

Methods

This study was retrospective and obtained approval from the bioethics committee (IFPS:KB/Oświadczenie nr 16/2021r). The beginning of data collection was the date of surgery and the medical history was analyzed from this point. The beginning of data collection was the day that they were diagnosed with chronic otitis media with effusion. In both groups, data were collected for 12 months. The difference in the number of children in the groups was due to a difficulty in collecting enough data from the second group. The institute where the data were collected was a quaternary care hospital, where otorhinolaryngologic surgeries were common, and so the number of children having a 12-month history of no surgery was low

Results

Discussion

Conclusion