Ventilation Tube Insertions for Pediatric Otitis Media with Effusion: With Adenoidectomy or Not

Abstract

Objective: Performing adenoidectomy or not in conjunction with ventilation tube insertion (VTI) to treat pediatric otitis media with effusion (OME) has been debated for decades. This study used population-based data to determine the recurrence rate of persistent OME with adenoidectomy or not in conjunction with VTI. Method: This study included all children less than 12 years old who underwent VTI in the year 2003 by using the NHI databank in Taiwan. We compare the recurrence rate and time to recurrence of persistent OME in children who received adenoidectomy in conjunction with VTI and VTI alone in a 3-year follow-up. Results: From 2736 cases evaluated, the children having both adenoidectomy and VTI had a lower recurrence rate of OME than those who had VTI alone ( P < .0001). The children under the age of 8 years having both adenoidectomy and VTI had a statistically significant lower recurrence rate of OME than those who had VTI alone ( P = .0384 for age 0-3years, P = .0286 for age 4-7years). There is no difference in OME recurrence with adenoidectomy or not in the age group 8 to 11 years ( P = .1539). There is no difference in time to recurrence in all age groups. Conclusion: Combined adenoidectomy and VTI for pediatric OME can reduce OME recurrence of tube re-insertion rate than that of VTI alone, especially in children under 8 years old. The time to recurrence seemed to be lengthened in the combined adenoidectomy and VTI group, but without statistical significance.