Impact of adenoidectomy alone or with ventilation tube for treatment of secretory otitis media in children

Abstract

Background: Adenoid surface in patients suffering from secretory otitis media is usually associated with bacterial biofilm. Adenoidectomy is thought to be effective in treatment of cases associated with secretory otitis media. Objective: Evaluating the role of adenoidectomy alone or in combination with ventilation tube insertion in improving the outcome of OM with effusion associated with adenoid hypertrophy. Patients and methods: This study included 40 children with recurrent or persistent secretory OM despite proper medical treatment for 3-6 months. They were divided into 2 equal groups. Group A treated by adenoidectomy with ventilation tube insertion and the group B was treated by adenoidectomy alone. These patients were evaluated preoperatively by plain X-ray nasopharynx lateral view and audiological assessment, adenoid specimen was taken for scanning by electron microscope for adenoid surface biofilm detection and grading. Postoperatively, we followed up the patients for 1 year to assess improvement and post-operative complications. Results: At the 1st follow up visit, Group A had higher rate of improvement than those who had adenoidectomy alone. Long term follow up (1 year) show significant higher rate of complications in those who were treated by adenoidectomy with ventilation tube 5 cases in comparison to only 2 cases of in Group B. There is no significant association between adenoid size and biofilm formation. Adenoid size and biofilm extension grade had no significant relation to postoperative outcome. Conclusion: Removal of adenoid was associated with relieve of OM with significant higher rate of complications in those undergoing adenoidectomy with ventilation tube insertion.