Clinical question
How effective and safe is adenoidectomy, either alone or in combination with ventilation tubes (grommets), for otitis media with effusion (OME) in children?
Bottom line
Adenoidectomy may have a small beneficial effect on the resolution of OME – fewer children who received adenoidectomy had persistent effusion at up to 3 months (low-certainty evidence) and up to 12 months (very-low-certainty evidence) of follow-up. For those who received adenoidectomy and ventilation tubes versus no treatment, there was an improvement in mean hearing threshold, but the evidence was very uncertain. This effect was much smaller after 1 and 2 years of follow-up, but it should be noted that many children in the control group had also received surgery by this time.
Caveat
There is a chance of haemorrhage from adenoidectomy, but the absolute risk is likely to be small, and the evidence was very uncertain. It is important to note that many of the included studies were undertaken several years ago. Since then, environmental risk factors for OME may have changed. This may have affected the relative influence of adenoid function on the development of OME, meaning the corresponding impact of adenoidectomy may be altered in children with OME today. Therefore, these results may not be fully applicable to current practice.
Context
OME is an accumulation of fluid in the middle ear cavity, and is common among young children. The fluid may cause hearing loss. When persistent, it may lead to developmental delay, social difficulty and poor quality of life. Management of OME includes watchful waiting, autoinflation, and medical and surgical treatment. Adenoidectomy has often been used as a potential treatment for this condition.
Cochrane Systematic Review
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