How effective is adenoidectomy for acute otitis media (AOM) and chronic otitis media with effusion (“glue ear”) in children?
Compared with non-surgical management or tympanostomy tubes
only, adenoidectomy with or without tympanostomy tubes confers
no benefit in children with AOM in terms of recurrence and duration
of AOM. Adenoidectomy in combination with a unilateral tympanostomy
tube has a beneficial effect on the resolution of glue
ear for the non-operated ear at 6 months and 12 months, respectively
(n = 3 trials), and a very small (<5dB) effect on hearing,
compared to a unilateral tympanostomy tube only. The trials were
too heterogeneous to pool in a meta-analysis. A small beneficial
effect of adenoidectomy on the resolution of effusion was also
seen in studies of adenoidectomy with or without myringotomy
versus non-surgical treatment or myringotomy only, and in studies
of adenoidectomy in combination with bilateral tympanostomy
tubes versus bilateral tympanostomy tubes only. The latter results
could not be pooled due to the heterogeneity of the trials.
The absence of a significant benefit of adenoidectomy on AOM
suggests routine surgery for this indication is not warranted. The
effects of adenoidectomy on changes to the tympanic membrane
or cholesteatoma are unknown.
Both acute and chronic middle ear infections (AOM and glue ear)
are very common in children. Adenoidectomy is often performed
for these conditions.