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Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion.
N Engl J Med 1987; 317(23):1444-51NEJM

Abstract

To study the effectiveness of adenoidectomy and of the placement of tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 children, aged four through eight years, to receive bilateral myringotomy and no additional treatment (Group 1), placement of tympanostomy tubes (Group 2), adenoidectomy (Group 3), or adenoidectomy and placement of tympanostomy tubes (Group 4). The 491 children who underwent one of these treatments were examined at six-week intervals for up to two years. The mean time spent with effusion of any type in either ear over the two-year follow-up in the four groups was 51, 36, 31, and 27 weeks, respectively (P less than 0.0001), comparing Group 1 with each of the other groups. Hearing was equivalent in Groups 2, 3, and 4, and was significantly better than in Group 1. The most frequent sequela, purulent otorrhea, occurred one or more times in 22, 29, 11, and 24 percent of the subjects in Groups 1, 2, 3, and 4, respectively (P less than 0.001). Adenoidectomy plus bilateral myringotomy lowered the overall post-treatment morbidity (as measured by hearing acuity in the most severely affected ear [P = 0.0174] and the number of surgical retreatments required [P = 0.009]) more than did tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. We conclude that adenoidectomy should be considered when surgical therapy is indicated in children four to eight years old who are severely affected by chronic otitis media with effusion.

Authors+Show Affiliations

Division of Otorhinolaryngology, University of Texas Health Science Center, San Antonio 78284-7777.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

3683478

Citation

Gates, G A., et al. "Effectiveness of Adenoidectomy and Tympanostomy Tubes in the Treatment of Chronic Otitis Media With Effusion." The New England Journal of Medicine, vol. 317, no. 23, 1987, pp. 1444-51.
Gates GA, Avery CA, Prihoda TJ, et al. Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion. N Engl J Med. 1987;317(23):1444-51.
Gates, G. A., Avery, C. A., Prihoda, T. J., & Cooper, J. C. (1987). Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion. The New England Journal of Medicine, 317(23), pp. 1444-51.
Gates GA, et al. Effectiveness of Adenoidectomy and Tympanostomy Tubes in the Treatment of Chronic Otitis Media With Effusion. N Engl J Med. 1987 Dec 3;317(23):1444-51. PubMed PMID: 3683478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion. AU - Gates,G A, AU - Avery,C A, AU - Prihoda,T J, AU - Cooper,J C,Jr PY - 1987/12/3/pubmed PY - 2001/3/28/medline PY - 1987/12/3/entrez SP - 1444 EP - 51 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 317 IS - 23 N2 - To study the effectiveness of adenoidectomy and of the placement of tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 children, aged four through eight years, to receive bilateral myringotomy and no additional treatment (Group 1), placement of tympanostomy tubes (Group 2), adenoidectomy (Group 3), or adenoidectomy and placement of tympanostomy tubes (Group 4). The 491 children who underwent one of these treatments were examined at six-week intervals for up to two years. The mean time spent with effusion of any type in either ear over the two-year follow-up in the four groups was 51, 36, 31, and 27 weeks, respectively (P less than 0.0001), comparing Group 1 with each of the other groups. Hearing was equivalent in Groups 2, 3, and 4, and was significantly better than in Group 1. The most frequent sequela, purulent otorrhea, occurred one or more times in 22, 29, 11, and 24 percent of the subjects in Groups 1, 2, 3, and 4, respectively (P less than 0.001). Adenoidectomy plus bilateral myringotomy lowered the overall post-treatment morbidity (as measured by hearing acuity in the most severely affected ear [P = 0.0174] and the number of surgical retreatments required [P = 0.009]) more than did tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. We conclude that adenoidectomy should be considered when surgical therapy is indicated in children four to eight years old who are severely affected by chronic otitis media with effusion. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/3683478/Effectiveness_of_adenoidectomy_and_tympanostomy_tubes_in_the_treatment_of_chronic_otitis_media_with_effusion_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM198712033172305?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -