الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 75 |  |  |
| | | from | 75 | | |
Abstract
Otitis media with effusion (OME) is an inflammatory disorder of the middle ear that is characterised by the presence of endotympanic fluid without any sign or symptom of acute ear infection, which may lead to hearing loss (HL) or long-term sequelae and have a negative impact on speech development and behaviour. It is estimated that up to 90% of children experience at least one episode before reaching school age (60% of the episodes occur in the first 2 years of life), and that a total of 2.2 million pediatric episodes a year are diagnosed in the United States alone. Surgical treatment may take the form of tympanostomy tube insertion or adenoidectomy with or without myringotomy or tube insertion. Adenoidectomy alone has been considered in children with OME associated with nasal obstruction, chronic rhinosinusitis or adenoiditis, or those who have previously undergone repeat surgery for OME and has been reported to be most beneficial in children aged >3 years regardless of adenoid size. Adenoidal hypertrophy and the closeness of the adenoids to the ostium of the Eustachian tube seem to be an important factor in the pathogenesis of OME. Adenoidal bacterial biofilms are significantly more prevalent near the ostium of eustachian tube suggesting that the adenoids are a reservoir for biofilm-producing bacteria that can spread through the Eustachian tube to colonise the middle ear. The aim of surgery in patients with OME and adenoidal hypertrophy should be the complete removal of the adenoids not only in order to restore Eustachian tube patency, but also to ensure the total eradication of bacterial biofilms in spite of debate around the role of adenoidectomy as some authors think that adenoidectomy with or without tube insertion provided no advantage to young children with chronic OME. This study aimed to evaluate the effectiveness of adenoidectomy in prevention of recurrent otitis media with effusion. This prospective randomized control study was conducted on 60 patients aged between 2-12 years old of both genders undergoing middle ear effusion (MEE). Patients were divided into two groups. Each group includes 30 patients; group I: myringotomy and tympanostomy tube insertion with adenoidectomy were performed and group II: myringotomy and tympanostomy tube insertion only without adenoidectomy were performed. Summary of our Results: The age ranged from 2 to 12 years with a mean value (± SD) of 6.83 (±3.3) years in group I and ranged from 2 to 12 years with a mean value (± SD) of 6.4 (±3.14) years in group II. The age was insignificantly different between both groups (P = 0.604). The sex was insignificantly different between both groups (P = 0.601). Laterality was bilateral in 19 (63.33%) cases and unilateral in 11 (36.67%) cases in group I and was bilateral in 20 (66.67%) cases and unilateral in 10 (33.33%) cases in group II. Laterality was insignificantly different between both groups (P = 0.786). The tubal life ranged from 3 to 6 months with a mean value (± SD) of 4.8 (±1.03) months in group I and ranged from 3 to 6 months with a mean value (± SD) of 4.5 (±1.11) months in group II. The tubal life was insignificantly different between both groups (P = 0.232). Number of episodes of MEE after extrusion of tympanostomy tube ranged from 0 to 2 with a mean value (± SD) of 0.4 (±0.67) in group I and ranged from 0 to 2 with a mean value (± SD) of 0.5 (±0.68) in group II. The number of episodes of MEE after extrusion of tympanostomy tube was insignificantly different between both groups (P = 0.449).