University of Toronto researchers have found that children who are hospitalized with ear infections are much less likely to need further surgery if they undergo a two-part procedure - an adenoidectomy (the removal of adenoid glands) in conjunction with the insertion of tiny tubes in the ear drums - instead of just tube surgery.
Ear infections are the most common reason for visits by children to physicians and can cost the Canadian economy over $600 million annually. When medical therapy fails, standard treatment is a myringotomy - the removal of excess fluid from the middle ear through an incision in the eardrum, followed by the insertion of tiny tubes to maintain proper drainage of the infected fluid. Annually, over 20,000 children in Ontario receive tube surgery.
With funding from the Canadian Institutes of Health Research, U of T researchers found that the two-pronged approach reduced the need for further surgery and hospital readmissions for ear infection-related reasons by half when compared to the tube surgery alone. "This study demonstrates the effectiveness of adjuvant surgery, particularly adenoidectomy, for children with ear infections," says Professor Peter Coyte of the department of health administration in the Faculty of Medicine and lead author of the study that appears in the April 19 edition of the New England Journal of Medicine.
Of the 37,316 children in Ontario who received tube surgery as their first surgical intervention between 1995 and 1997, almost three-quarters received tube surgery alone while the rest also received adjuvant, or additional, surgery: 11 percent received an adenoidectomy, one per cent a tonsillectomy, while 16 per cent had both their tonsils and adenoid glands removed.
Within one year of the initial operation, 10 per cent of the children who underwent only tube surgery were readmitted, compared to four per cent of those with adjuvant adenoidectomy. Within two years, readmission rates increased to 24 and 12 p
Contact: Steven de Sousa
University of Toronto