Comparison Of Tympanostomy Tube Insertion Combined With Adenoidectomy And Tympanostomy Tube Insertion Only In Otitis Media With Effusion Patients Having Adenoid Hypertrophy

Objective To determine whether Adenoidectomy combined with Tympanostomy Tube insertion surgery is better than Tympanostomy Tube insertion surgery only in patients having Otitis Media with Effusion(OME)and adenoid hypertrophy in a group of children aged between 4 to 14 years old.MethodA retrospective study was conducted at the Otorhinolaryngology Department of The First Affiliated Hospital of Zhengzhou University including data of patients having adenoid hypertrophy and OME persisting more than 3 months despite medical or conservative treatment from January 2014 to December2017.The patients were separated in two groups,TT+Ad group(patients who received Tympanostomy Tube surgery and adenoidectomy)and TT(Tympanostomy Tube surgery only).Pure Tone Average and Auditory Brainstem Response results at 6 months and 1 year intervals in both groups were compared.The curative efficacy,recurrence rate,middle ear effusion duration and healing time in both groups were also analyzed.SPSS version 22 was chosen for statistical analysis.Results A total of 220 patients(373 ears)were selected for this study including 134 males(232 ears)and 86females(141 ears)with mean age of(7.82±2.85)years.The patients were distributed as follows: 110patients(TT+Ad)group and 110 patients(TT only)group.In terms of age,gender and history of the patients,no difference was noted.The curative efficacy of the(TT+Ad)group was 94.5% and 79.1% in the(TT only)group and the difference between them was statistically significant(p<0.05).The Mean of Pre-operative,6 months post-operative and 1 year post-operative Air-Bone gaps and Auditory Brainstem Response were compared between both groups.Post-operative hearing in the(TT+Ad)group was better than the(TT only)group and the difference between both groups was statistically significant(p<0.05).The average duration of middle ear effusion in(TT+Ad)group was(8.1±1.32)days and the average time taken for healing was(14.2±3.14)days while in(TT only)group,the average middle ear effusion duration were(10.8±1.87)days and healing time(14.6±3.42)days.In terms of recurrence,6.04% had relapse in the study group(TT+Ad)and 14.7% in(TT only)group with both having statistical significance(p<0.05).However no statistical difference was noted in healing time between both groups.(p>0.05)Conclusion Overall the data in our study suggests that OME patients with adenoid hypertrophy benefit more from Tympanostomy tube insertion combined with adenoidectomy compared to Tympanostomy tube insertion only in that not only better hearing results are attained but the time taken for middle ear effusion to clear is lesser and there is also lower incidence rate for effusion recurrence.