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 Vol. 18 No. 3, September 2007
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AAP Grand Rounds 18:30-31 (2007)
© 2007 American Academy of Pediatrics

OTOLARYNGOLOGY

Adenoidectomy May Decrease the Need for Repeat Ear Tubes

Source: Kadhim AL, Spilsbury K, Semmens JB, et al. Adenoidectomy for middle ear effusion: a study of 50,000 children over 24 years. Laryngoscope. 2007;177:427–433; doi: 10.1097/MLG.0b013e31802c938b

The first 20% of the full text of this article appears below.

The role of the adenoid in the pathophysiology of chronic otitis media remains controversial. In children with chronic middle ear effusion, an enlarged adenoid may interfere with normal Eustachian tube function. In children with recurrent acute otitis media, the adenoid may serve as a reservoir for pathogenic organisms and chronic Eustachian tube inflammation. Investigators from Princess Margaret Hospital and Curtin University of Technology in Australia reviewed information in a large administrative database to compare the incidence of repeat myringotomy with ventilation tube insertion (MVTI) in children from Western Australia who did, or did not, have additional pharyngeal surgery (adenoidectomy, adenotonsillectomy, tonsillectomy) at the time of initial MVTI. Socioeconomic data and location of medical procedures were collected to account for potential confounding. The researchers also recorded information on chromosomal abnormalities, cleft palate, and other ear, nose, and facial congenital abnormalities that might predispose children to middle ear surgery. At the time of the MVTI surgery, patients were identified as having adenoid and/or tonsil disease based on diagnosis codes. Finally, data on hemorrhage (based on ICD codes), length of hospital stay, and readmissions within 30 days because of hemorrhage were collected.

Between 1981 and 2004, 51,373 children less than 10 years of age were identified who underwent at least one . . . [Full Text of this Article]

Joshua A. Gottschall, MD, FAAP
Pediatric Otolaryngology, Head and Neck Surgery, Kaiser Permanente Medical Center, Oakland, CA