DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20212448

Surgical versus medical intervention for the treatment of concurrent otitis media with effusion in children undergoing adenotonsillectomy in the age group 5-15 years: a prospective comparative study

Davis T. Pulimoottil, Padmanabhan Karthikeyan, Nirmal C. Venkataramanujam, Ramiya R. Kaipuzha, Angel Cham Philip

Abstract


Background: The aim was to study the prevalence of otitis media with effusion (OME) among children with concurrent chronic adenotonsillitis or adenoid hypertrophy and to study the outcomes of various modalities of treatment.

Methods: Over 2 years, 100 children in the age group 5-15 years undergoing adenotonsillectomy were included of which, patients diagnosed with concurrent OME were sequentially allocated into 2 groups. Group I was adenotonsillectomy and medical therapy and group II was adenotonsillectomy and myringotomy with grommet insertion.

Results: The prevalence of OME among children in the age group 5-15 years undergoing adenotonsillectomy is 21%. There is a statistically significant relationship between male gender, middle socioeconomic status, joint families, history of bottle feeding, history of exposure to parental smoking and prevalence of OME. Group II fared better in terms of clinical outcomes following surgical intervention, with a success rate of 100%.

Conclusions: Surgical treatment for OME has a better clinical outcome as compared to just medical therapy for the same.


Keywords


Otitis media with effusion, Adenotonsillectomy, Male, Bottle feeding, Parental smoking

Full Text:

PDF

References


Sinha V, Patel BH, Sinha S. Incidence of uncomplained secretory otitis media in patients undergoing adenotonsillectomy. Indian J Otolaryngol Head Neck Surg. 2005;57(2):110-1.

Kadhim AL, Spilsbury K, Semmens JB, Coates HL, Lannigan FJ. Adenoidectomy for middle ear effusion: a study of 50,000 children over 24 years. Laryngoscope. 2007;117(3):427-33.

Nguyen LHP, Manoukian JJ, Yoskovitch A, Al-Sebeih KH. Adenoidectomy: selection critera for surgical cases of otitis media. Laryngoscope. 2004;114(5):863-6.

Maw AR, Bawden RR. Spontaneous resolution of severe chronic glue ear in children and the effect of adenoidectomy, tonsillectomy and insertion of ventilation tubes (grommets). BMJ. 1993;306(6880):756-60.

Coyte PC, Croxford R, McIsaac W, Feldman W, Friedberg J. The role of adjuvant adenoidectomy and tonsillectomy in the outcome of the insertion of tympanostomy tubes. N Engl J Med. 2001;344(16):1188-95.

Casselbrant ML, Mandel EM, Rockette HE, Kurs-Lasky M, Fall PA, Bluestone CD. Adenoidectomy for otitis media with effusion in 2 to 3 year old children. Int J Pediatr Otorhinolaryngol. 2009;73(12):1718-24.

Austin DF. Adenoidectomy for secretory otitis media. Arch Otolaryngol Head Neck Surg. 1989;115(8):936-9.

Maw AR. Chronic otitis media with effusion (glue ear) and adenotonsillectomy: a prospective randomized controlled study. Br Med J (Clin Res Ed). 1983;287(6405):1586-8.

Szeremeta W, Parameswaran MS, Isaacson G. Adenoidectomy with laser or incisional myringotomy for otitis media with effusion. Laryngoscope. 2000;110:342-5.

Black NA, Sanderson CFB, Freeland AP, Vessey MP. A randomised controlled trial of surgery for glue ear. BMJ. 1990;300(6739):1551-6.

Aardweg MTVD, Schilder AG, Herkert E, Boonacker CW, Rovers MM. Adenoidectomy for otitis media in children. Cochrane Database Syst Rev. 2010;1:007810.

Tos M, Holm-Jensen S, Sorensen CH, Morgensen C. Spontaneous course and frequency of secretory otitis media in 4-year-old children. Arch Otolaryngol, 1982;108(1):4-10.

Rovers MM, Straatman H, Zielhuis GA, Ingels K, Wilt GJVD. Seasonal variation in the prevalence of persistent otitis media with effusion in one-year-old infants. Paediatr Perinat Epidemiol. 2000;14:268-74.

Rovers MM, Straatman H, Ingels K, Wilt GJVD, van den Broek P, Zielhuis GA. The effect of ventilation tubes on language development in infants with otitis media with effusion: a randomized trial. Pediatrics. 2000;106(3):42.

Midgley EJ, Dewey C, Pryce K, Maw AR. ALSPAC study team. The frequency of otitis media with effusion in British pre-school children: a guide for treatment. Clin Otolaryngol Allied Sci. 2000;25(6):485-91.

Martines F, Bentivegna D, Maira E, Sciacca V, Martines E. Risk factors for otitis media with effusion: case-control study in Sicilian school children. Int J Pediatr Otorhinolaryngol. 2011;75(6):754-9.

Sophia A, Isaac R, Rebekah G, Brahmadathan K, Rupa V. Risk factors for otitis media among preschool, rural Indian children. Int J Pediatr Otorhinolaryngol. 2010;74(6):677-83.

Maerx J, Osguthorpe JD, Parsons G. Day care and the incidence of otitis media in young children. Otolaryngol Head Neck Surg. 1995;112(6):695-9.

Dewey C, Midgeley E, Maw R, The ALSPAC study team. The relationship between otitis media with effusion and contact with other children in a British cohort studied from 8 months to 3.5 years of age. Int J Pediatr Otorhinolaryngol.2000;55(1):33-45.

Abrahams SW, Labbok MH. Breastfeeding and otitis media: a review of recent evidence. Curr Allergy Asthma Rep. 2011;11(6):508-12.

Engel J, Anteunis L, Volovics A, Hendriks J, Marres E. Risk factors of otitis media with effusion during infancy. Int J Pediatr Otolaryngol. 1999;48(3):239-49.

Butler CC, Voort JHVD. Oral or topical nasal steroids for hearing loss associated with otitis media with effusion. Cochrane Database Syst Rev. 2002;4:001935.

Shapiro GG, Bierman CW, Furukuwa CT. Treatment of persistent eustachian tube dysfunction with aerosolized nasal dexamethasone phosphate versus placebo. Ann Allergy. 1982;49(2):81-5.

Mandel EM, Casselbrant ML, Rockette HE, Fireman P, Kurs-Lasky M, Bluestone CD. Systemic steroid for chronic otitis media with effusion in children. Pediatrics. 2002;110(6):1071-80.

Rosenfeld RM, Post JC. Meta-analysis of antibiotics for the treatment of otitis media with effusion. Otolaryngol Head Neck Surg. 1992;106(4):378-86.