Efficacy and safety of tympanostomy tube insertion combined with adenoidectomy in children with recurrent otitis media: impact on effusion clearance time, otitis media recurrence rate, and hearing improvement

鼓膜置管联合腺样体切除术治疗复发性中耳炎患儿的疗效和安全性:对积液清除时间、中耳炎复发率和听力改善的影响

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Abstract

OBJECTIVE: To investigate whether adenoidectomy (Ad) combined with tympanostomy tube insertion (TTI) would provide additional benefits for children with recurrent otitis media (ROM). METHODS: We analyzed the medical records of 160 children aged 3 to 10 years who underwent ROM surgery at Guangdong Medical University Panyu He Xian Memorial Hospital between December 2019 and December 2024. These children were divided into two groups according to their treatment regimen: TTI only group (n=64) and TTI + Ad group (n=96). Clinical measures, including tympanic membrane healing, middle ear effusion clearance, as well as complications and recurrent otitis media, were compared between the two groups. Pure tone audiometry and tympanogram were performed at 2 weeks and 6 months postoperatively. RESULTS: The TTI + Ad group demonstrated significantly faster middle ear effusion clearance, lower recurrence rate of otitis media, and better improvement in hearing at speech frequency range, compared with the TTI only group. Postoperatively, the tympanogram of TTI + Ad group showed a higher proportion of type A curve, suggesting better middle ear function recovery. Multivariate logistic regression analysis further confirmed that TTI + Ad was a protective factor for treatment failure (OR=0.267) and disease recurrence (OR=0.275). CONCLUSION: The combination of TTI and Ad is more effective than TTI alone in treating ROM. This combined surgical approach not only facilitates faster clearance of middle ear effusion and reduces the risk of recurrence but also contributes to better recovery of the child's hearing.

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