A clinical study to determine the effects of adenoidectomy in cases of secretory otitis media in school going children


  • M. Rama Sridhar Professor & HOD, Department of ENT, Mamata Medical College, Khammam, Telangana




Secretory otitis media, Adenoidectomy, Pure tone audiometry


Background: Secretory otitis media (SOM) is common otological symptom in children. If left untreated it leads to hearing and speech impairment. Surgical management is effective in serious cases. The present study was done with the objective to assess the effect of adenoidectomy by pure tone and impedance audiometry in cases of SOM with hypertrophied adenoids.

Methods: This study comprised 50 cases, who were aged 5-12 years and diagnosed as SOM with adenoid hypertrophy. It was carried out for a period one and half years from December 2015 to July 2017 at Mamata Medical College and Research Hospital, Khammam, Telangana. After detailed history and clinical examination, investigations such as pure tone audiogram, impedance audiometry, X-ray nasopharynx and diagnostic nasal endoscopy were carried out to confirm the diagnosis. All patients were posted for adenoidectomy and when indication was present tonsillectomy was also done. They were followed up at 1st, 3rd and 6th month for pure tone audiometry and impedance was done at 6th month of surgery.

Results: In this study, maximum number (60%) of cases belonged to 5-7 years age group, with slight male preponderance (56%). On pure tone audiometry 68% had 16-25 dB and 32% had 26-40 dB hearing loss and average being 24.95 dB. On impedance only 14% had peak preoperatively. Postoperatively, no peak/peak conversion was seen in 33% of cases and mean A-B gap improvement at 1st, 3rd and 6th month was 13 dB, 13.2 dB and 12.7 dB respectively (p value is 0.0001,<5%) when compared to preoperative findings.

Conclusion: Adenoidectomy is effective in the management of middle ear infection in children having hypertrophied adenoids.


Tos M. Epidemiology and natural history of secretory otitis. Am J Otol. 1984;5(6):459–62.

Paparella MM, Jung TK, Goycoolea MV. Otitis Media with Effusion. In: Paparell and Shumrich Otolaryngology. Volume 3. Issue 2. London: Saunders; 1990: 1317-1342.

Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope. 2003;113(10):1645–57.

Gates GA. Acute otitis media and otitis media with effusion. In: Cummings CW, Flint PW, Haughey BH, Robbins KT, Thomas JR, Harker LA, Richardson MA, Schuller DE, editors. Pediatric Otolaryngology: Head and Neck Surgery. 4th edition. USA; Mosby: 2005: 4445-4468.

Eavey RD. Abnormalities of the neonatal ear: otoscopic observations, histological observations, and a model for contamination of the middle ear by cellular contents of amniotic fluid. Laryngoscope. 1993;103:1-31.

Capaccio P, Torretta S, Marciante GA, Marchisio P, Forti S, Pignataro L. Endoscopic Adenoidectomy in Children With Otitis Media With Effusion and Mild Hearing Loss. Clin Exp Otorhinolaryngol. 2016;9(1):33-8.

Kocyigit M, Ortekin SG, Cakabay T, Ozkaya G, Bezgin SU, Adali MK. Frequency of Serous Otitis Media in Children without Otolaryngological Symptoms. Int Arch Otorhinolaryngol. 2017;21(2):161-4.

Khan F, Asif M, Farooqi GH, Shah SA, Sajid T, Ghani R. Management outcome of secretory otitis media. J Ayub Med Coll Abbottabad 2006;18(1).

Reddy VG. Secretory otitis media. Indian J Otol. 1998;4(4):157-60.

Fria TJ, Cantekin EI and Eichler JA. Hearing acuity of children with otitis media with effusion. Arch Otolaryngol. 1985;111(1):10-6.

Schilder AG, Zielhuis GA, van den. Broek P. The otological profile of a cohort of Dutch 7.5-8 year olds. Clinical Otolaryngol. 1993;18:48-54.

Maw AR, Herod F. Otoscopic impedance and audiometric findings in glue ear treated by adenoidectomy and tonsillectomy. A prospective randomized study. Lancet. 1986; 1399-1402.

Rosenfeld RM, Schwartz SR, Pynnonen MA, Tunkel DE, Hussey HM, Fichera JS, et al. Clinical practice guideline: Tympanostomy tubes in children. Otolaryngol Head Neck Surg. 2013;149(1):1–35.

Paradise JL, Bluestone CD, Rogers KD, Taylor FH, Colborn DK, Bachman RZ, et al. Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement. Results of parallel randomized and nonrandomized trials. JAMA. 1990;263:2066–73.

Black NA, Sanderson CFB. Freeland AB, Vessey MP. A randomized controlled trial of surgery for glue ear. BMJ. 1990;300:1551-6.

Satish HS, Sarojamma, Anjan Kumar AN. A Study on Role of Adenoidectomy in Otitis Media with Effusion. IOSR-JDMS. 2013;4(6):20-4.






Original Research Articles