Is Adenoidectomy Enough as a Surgical Treatment for Otitis Media with Effusion Caused by Adenoid Hypertrophy?

Hassan Al-Baldawi, Mohammad

	Is Adenoidectomy Enough as a Surgical Treatment for Otitis Media with Effusion Caused by Adenoid Hypertrophy?
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 24, Issue 1, 2011, Pages 61-65
Author
Mohammad Hassan Al-Baldawi
Abstract
Background :- Adenoid diseases are one of the major ENT problems in pediatrics that require surgery in high incidence of children especially in primary school as it affects the school performance due to recurrent otitis media & otitis media with effusion with resultant hearing loss. Objectives :-Comparison between adenoidectomy (As) alone & adenoidectomy with myringotomy (Ms) & grommet insertion (Gs) in children with otitis media with effusion ( OME)due to adenoid hypertrophy (AH) describing the results & postoperative complications of each operation in order to get the best helpful surgical method to treat this disease & prevent further episodes. Patients & Methods: - Fourty primary school children enrolled in this study who were attended department of otolaryngology in Al – Yermouk teaching hospital in a period from February 2007 to December 2008. All children have bilateral OME & hearing loss due to AH , they were divided into two groups each with 20 children ( i.e. 40 ears ) & underwent surgery ( the 1st group with As alone & the 2nd one with AsMsGs ) with postoperative follow up for one year by clinical evaluation of the results & postoperative complications. Results :- Postoperative clinical evaluation of both 1st & 2nd groups revealed improvement in 15 (37.5%) & 38 (95%) ears respectively, unilateral improvement encountered in 9 (22.5%) & 18 (45%) ears respectively , while bilateral improvement seen in 6 (15%) & 20 (50%) ears respectively. On the other hand recurrence & failure was seen in 25 (62.5%) & 2 (5%) ears respectively , this recurrence was unilateral in 13(32.5%) & 2(5%) ears respectively & bilateral in 12(30%) & 0 (0%) ears respectively .Recurrence was challenged mainly within 3 months in the 1st group (i.e. short term benefit ) & within 6 months in the 2nd group with longer lasting improvement because the operation include AsMsGs which achieve drainage & ventilation of the middle ear. Postoperative complications are encountered only in the 2nd group with AsMsGs as it utilized MsGs, but these complications are not associated with remote sequelae. Conclusions :- As alone seems to have no postoperative morbidity but with less beneficial results , whereas AsMsGs showed better improvement of hearing & the recurrence rate decreased remarkably as compared with As alone. However, despite Gs had relatively more complications, AsMsGs is strongly advisable than As alone for treating OME due to AH & prevention of its recurrence. Key words: - Adenoidectomy, Otitis Media with Effusion
Keywords
Adenoidectomy; Otitis media with effusion

Statistics Article View: 158 PDF Download: 135