Abstract
OBJECTIVE: To assess the efficacy of combined tympanostomy tube insertion (TTI) and adenoidectomy (Ad) versus Ad alone in the treatment of otitis media with effusion (OME) in children. METHODS: Clinical data of 145 children with OME who underwent surgical treatment in Jiaxing University Affiliated TCM Hospital from January 2022 to November 2023, were retrospectively analyzed. Patients were grouped based on whether or not Ad was performed with TTI: children who underwent Ad alone were grouped as Ad group (n=71), and children who underwent a combined TTI and Ad were grouped as TTI+Ad group (n=74). Clinical efficacy, clinical indicators (recovery of hearing, disappearance of tinnitus, eardrum healing, and disappearance time of middle ear effusion), serum levels of inflammatory factors, recurrence, and incidence of complications were compared between the two groups. RESULTS: Combined TTI+Ad resulted in a significantly better therapeutic effect three months after the surgery compared Ad alone (P<0.05). Combined treatment was associated with significantly shorter time needed for hearing recovery, disappearance of tinnitus, eardrum healing, and disappearance of middle ear effusion (P<0.05). Combined procedure significantly lowered levels of inflammatory factors (P<0.05), and was associated with lower postoperative recurrence rate (P<0.05) compared to Ad alone. There was no significant difference in the incidence of complications between the two methods of surgical OME treatment (P>0.05). CONCLUSIONS: Compared to Ad alone, combined TTI+Ad treatment is equally safe and more effective in the treatment of OME in children. This surgical approach is associated with reduced local inflammatory reactions and lower recurrence rate.