The role of adjuvant adenoidectomy and tonsillectomy in the outcome of the insertion of tympanostomy tubes
Article Abstract:
Removing a child's adenoids and tonsils at the time a tympanostomy tube is placed to treat otitis media may reduce the rate of recurrent infection. Otitis media is an ear infection that is usually treated by inserting a tube into the eardrum to drain the ear.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2001
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Physician and Population Determinants of Rates of Middle-Ear Surgery in Ontario
Article Abstract:
There is a wide variation in the use of tympanostomy tubes for treating childhood ear infections in Ontario, Canada. In a study of of 75,358 hospitalizations for tympanostomy tube placement, researchers found a 10-fold difference between the counties with the lowest use and those with the highest use.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2001
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Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement
Article Abstract:
Otitis media is a middle-ear infection that is common in children. The infection is frequently recurrent, and removal of the adenoids (adenoidectomy) is sometimes performed to control this condition. However, there has been some controversy as to the effectiveness of this procedure. Two parallel studies were conducted to assess the efficacy of adenoidectomy in children with recurrent otitis media. These children had been previously treated with tympanostomy-tube placement, a procedure in which tubes are placed through the tympanic membrane of the ear to allow ventilation; in all the children the infection developed again. Out of a total of 213 children who met the study criteria, 99 were randomly assigned to either the adenoidectomy or the control group. The other 114 children who participated had parents who did not agree to random assignment; in these cases the parents chose which treatment they preferred. The subjects were monitored over a period of up to three years. A bias occurred during both trials as a result of the withdrawal of very sick children from the control group; they were subsequently placed in the adenoidectomy group. In spite of this, the adenoidectomy group had better outcomes than the control group. During the first and second years, the patients who had adenoidectomies had 47 and 37 percent less time with otitis media, respectively, than the control group. Also for years one and two respectively, the adenoidectomy group had 28 and 35 percent fewer severe episodes of infection than the control subjects. These results are much more conclusive than those of other studies that have investigated the efficacy of adenoidectomy in the treatment of otitis media. In general, this procedure is recommended as treatment for otitis media after failure of tympanostomy-tube placement. However, caution is urged when determining whether or not adenoidectomy should be performed in children with chronic otitis media; some children outgrow this condition without surgical intervention. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
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