DOES ADENOIDECTOMY HAVE AN ADJUVANT EFFECT ON VENTILATION TUBE INSERTION AND THUS REDUCE THE NEED FOR RETREATMENT

Two hundred and twenty-two children with bilateral otitis media with e ffusion were followed for 5 years. A ventilation tube was inserted int o one ear only and reinserted if the condition had not resolved. The n eed for reinsertion in 139 children in whom the adenoids were also rem oved was compared with the 83 children treated by tube insertion alone . In the combined group in year 1, 91% required one tube compared with 62% treated with only a tube. By year 5, 66% of the combined group re quired one tube compared with 32.5% in those without adenoidectomy. Th ere was some relationship between tube reinsertion and age, and also w ith parental smoking. It is possible that the combination of adenoidec tomy with tube insertion may prove more cost-effective than tube inser tion in selected cases alone. In addition, once adenoidectomy becomes more established as a day case procedure, the cost benefit will be mor e advantageous in those children treated with adenoidectomy and a tube compared with those treated with only a tube.