In the Journals

Tubes, adenoidectomy decreased OME duration

The length of time children experienced otitis media with effusion was decreased among those who had both insertion of tympanostomy tubes and adenoidectomy. These procedures also improved hearing in the short term, according to study results.

Ina F. Wallace, PhD, of the division for health services and social policy research at RTI International, and colleagues analyzed randomized controlled trials, nonrandomized trials and cohort trials that compared myringotomy, adenoidectomy, tympanostomy tubes (tubes), and watchful waiting to determine the effectiveness of each method. The researchers published their findings in a recent issue of Pediatrics.

Tubes decreased time with otitis media with effusion (OME) and improved hearing more frequently than watchful waiting, myringotomy or both.

Adenoidectomy alone or with tubes decreased the duration of OME and improved hearing compared with watchful waiting or myringotomy.

Language, cognitive outcomes or academic outcome improvements did not differ between tubes and watchful waiting.

Postsurgical hemorrhage was increased with adenoidectomy. Tubes caused otorrhea and tympanosclerosis more often than the other procedures.

“Overall, we found a small and uneven body of evidence across treatment comparisons and outcomes,” the researchers wrote. “Compared with watchful waiting or myringotomy, we found strong and consistent evidence that tubes decreased effusion and improved hearing over a short period but did not affect speech, language or other functional outcomes. Weaker evidence suggested that tube placement also increased the rate of side effects, such as otorrhea and tympanosclerosis. Although adenoidectomy decreases the number of children with OME in the short-term relative to watchful waiting, less is known about its long-term outcomes, particularly with respect to functional outcomes.”

Disclosure: See study for a full list of researchers’ financial disclosures.

The length of time children experienced otitis media with effusion was decreased among those who had both insertion of tympanostomy tubes and adenoidectomy. These procedures also improved hearing in the short term, according to study results.

Ina F. Wallace, PhD, of the division for health services and social policy research at RTI International, and colleagues analyzed randomized controlled trials, nonrandomized trials and cohort trials that compared myringotomy, adenoidectomy, tympanostomy tubes (tubes), and watchful waiting to determine the effectiveness of each method. The researchers published their findings in a recent issue of Pediatrics.

Tubes decreased time with otitis media with effusion (OME) and improved hearing more frequently than watchful waiting, myringotomy or both.

Adenoidectomy alone or with tubes decreased the duration of OME and improved hearing compared with watchful waiting or myringotomy.

Language, cognitive outcomes or academic outcome improvements did not differ between tubes and watchful waiting.

Postsurgical hemorrhage was increased with adenoidectomy. Tubes caused otorrhea and tympanosclerosis more often than the other procedures.

“Overall, we found a small and uneven body of evidence across treatment comparisons and outcomes,” the researchers wrote. “Compared with watchful waiting or myringotomy, we found strong and consistent evidence that tubes decreased effusion and improved hearing over a short period but did not affect speech, language or other functional outcomes. Weaker evidence suggested that tube placement also increased the rate of side effects, such as otorrhea and tympanosclerosis. Although adenoidectomy decreases the number of children with OME in the short-term relative to watchful waiting, less is known about its long-term outcomes, particularly with respect to functional outcomes.”

Disclosure: See study for a full list of researchers’ financial disclosures.