Published online July 1, 2005
PEDIATRICS Vol. 116 No. 1 July 2005, pp. 185-189 (doi:10.1542/peds.2004-2253)
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Adenoidectomy Does Not Significantly Reduce the Incidence of Otitis Media in Conjunction With the Insertion of Tympanostomy Tubes in Children Who Are Younger Than 4 Years: A Randomized Trial

Sari Hammarén-Malmi, MD*, Harri Saxen, MD{ddagger}, Jussi Tarkkanen, MD§ and Petri S. Mattila, MD*

* Department of Otorhinolaryngology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
{ddagger} Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
§ Department of Pathology, Haartman Institute, University of Helsinki and HUSLAB, Helsinki University Central Hospital, Helsinki, Finland

Objective. To evaluate the efficacy of adenoidectomy in reducing the incidence of otitis media among children who are younger than 4 years and receive tympanostomy tubes.

Methods. A randomized trial was conducted at a tertiary center clinic. A total of 217 children who were aged 12 to 48 months and had recurrent acute otitis media (>3 episodes during the past 6 months) or chronic otitis media with effusion, no obstructive symptoms as a result of adenoid enlargement, and no previous surgical intervention were enrolled in the study. Adenoidectomy in conjunction with the insertion of tympanostomy tubes or insertion of tympanostomy tubes without adenoidectomy was studied. The number of otitis media episodes during the follow-up period of 12 months was measured.

Results. During the follow-up, the mean number of otitis media episodes was 1.7 among children who underwent adenoidectomy with concurrent insertion of tympanostomy tubes and 1.4 among children who received tympanostomy tubes only. The risk for recurrent otitis media (≥3 episodes) could not be reduced by adenoidectomy (odds ratio: 1.66; 95% confidence interval: 0.80–3.46).

Conclusion. Adenoidectomy does not significantly reduce the incidence of acute otitis media in otitis prone children who are younger than 4 years and receive tympanostomy tubes.

Key Words: otitis media • otitis media with effusion • adenoidectomy

Abbreviations: RAOM, recurrent acute otitis media • COME, chronic otitis media with effusion • CI, confidence interval

Accepted Jan 20, 2005.


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