Comparative evaluation of adenoidectomy and myringotomy with or without ventilation tube placement in the treatment of otitis media with effusion

Waseem Qadir Dar; Sajad Majid Qazi; Jasif Nisar

Volume : VII, Issue : IX, September - 2018

Comparative evaluation of adenoidectomy and myringotomy with or without ventilation tube placement in the treatment of otitis media with effusion

Waseem Qadir Dar, Sajad Majid Qazi, Jasif Nisar

Abstract :

Background:-OME is accumulation of non-purulent fluid in the middle ear cleft. 30-40% of children have recurrent episodes and 5-10% of cases last for more than 1 year. The primary site of pathology for OME is Eustachian tube and Adenoid hypertrophyis an important etiological factor attributed for its development. The surgical treatment of OME involves various combinations of adenoidectomy, myringotomy and ventilation tube placement. Myringotomy with aspiration of fluid has the direct aim of improving he� and preventingorganization of the secretion.

Methods:-The study was carried out in the department of ENT and HNS SMHS hospital of GMC Srinagar J&K India , a tertiary care institute in the period 2014–2017. Patients in the age group of 4-8 years diagnosed with Bilateral OME and fulfilling the inclusion criteria were allocated to undergo Adenoidectomy with or without tonsillectomy with Myringotomy and Ventilation Tube placement in one ear and Myringotomy without ventilation tube placement in the other ear in the same surgical setting. The ears in which myringotomy and grommet insertion was done , was labelled as A+M+T ear and the ear in which only myringotomy was done was labelled as A+M ear

Results:-A total of 30 patients in the age group of 4 to 8 years were included in the study. Out of which 25 (83.3%) belonged to 6-8 year age group. The mean age of patients was 6.6 year.The average preoperative AC threshold in A+M ear was 33.69�9.24 dB and in A+M+T ear was 37.14 �10.39 (p= .710) with mean difference of -3.45 and standard error difference of 2.54. The average AC threshold at 6 months in A+M ear was 16.82�4.85 dB, and in A+M+T ear was 16.50�2.66 (p=.080) with mean difference of .32 and standard error difference of 1.02. At 6 month follow up, 23 (76.6%) A+M ears had type A, 2 (6.6%) had type B, and 5 (16.6%) A+M ears had a type C tympanogram.

Conclusion:-Adenoidectomy with Myringotomy is as effective as adenoidectomy with ventilation tube Placement . High definition microscope /endoscope ensures complete aspiration of middle ear fluid and adenoidectomy clears obstruction