Adenoidectomy and Endoscopic Myringotomy with and without ventilation tube insertion for Treatment of Otitis Media with Effusion in 6-12 years old Children.

Abstract

Background: Otitis Media with Effusion (OME) is frequently caused by adenoiditis in children. OME is arguably one of the most common disorders that impairs hearing, speech development, and causes learning issues as a result. However, treatment options are debatable.

Aim: This study aims to evaluate if inserting a ventilation tube in conjunction with adenoidectomy is significantly superior to adenoidectomy in conjunction with myringotomy alone in terms of hearing outcome in 6-12 years old children with OME. Patients and Methods: In this prospective controlled clinical study, 33 children; 66 ears, with ages ranging from 6-12 years (19 males and 14 females) diagnosed as cases of bilateral OME and varying degrees of adenoid hypertrophy were included. The patients were randomized into two groups; group I (17 patients; 34 ears) underwent adenoidectomy and endoscopic myringotomy alone, whereas the 16 patients;32 ears, in group II underwent adenoidectomy and endoscopic myringotomy together with ventilation tube insertion. Measurement of pure tone hearing threshold was achieved pre-operatively and at the end of 1st and 3rd postoperative months. The means of the pure tone hearing threshold averages of the patients in both groups were compared. Independent samples t-test was used to define the association between the two means.

Results: Pre-operatively, the means of pure tone hearing threshold averages were 27.3 ± 2.670 dB in group I patients and 29.5 ± 2.865 dB in group II patients. At the end of 1st and 3rd post-operative months, the pure tone hearing threshold average means in group I patients were 18.2 ± 2.689dB and 14.8 ± 2.735 dB respectively, while the means in group II patients were 10.6 ± 1.742 dB and 3.5 ± 1.158 dB respectively. Independent samples t-test revealed a statistically significant difference between group I and group II patients regarding the means of pure tone hearing threshold averages at the end of the 1st and the 3rd post-operative months (P value=0.015 and 0.003 respectively).

Conclusion: In terms of hearing level, ventilation tube insertion in conjunction with adenoidectomy is statistically superior to adenoidectomy with myringotomy alone in the treatment of OME.