Adenoidectomy plus tympanostomy tube insertion versus adenoidectomy plus myringotomy in children with obstructive sleep apnoea syndrome

Vlastos, Ioannis; Houlakis, M; Kandiloros, Dimitrios; Manolopoulos, Leonidas; Ferekidis, E.; Yiotakis, Ioannis

doi:10.1017/s0022215110002549

Cited by 11 publications

(13 citation statements)

References 20 publications

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“…In a single study of children with sleep apnea and OME, 44 all of whom had adenoidectomy to treat that condition, tubes and myringotomy did not differ significantly in terms of any measured outcomes (insufficient evidence).…”

Section: Comparative Benefits and Harms For Patient Subgroupsmentioning

confidence: 99%

“…Seven studies that we newly identified [38][39][40][41][42][43][44] and 4 studies [45][46][47][48] reported in the Hellstrom et al 10 review examined outcomes for adenoidectomy plus different adjunctive therapies. Specifically, we compared the effectiveness of tubes when added to adenoidectomy with myringotomy or no surgery.…”

Section: Tympanostomy Tubes Plus Adenoidectomy Versus Myringotomy Plumentioning

confidence: 99%

“…44 Harms of Treatments for OME Most studies examining surgical comparisons reported on harms. Table 5 provides the findings and SOE for harms by treatment comparisons.…”

Section: Tympanostomy Tubes Plus Adenoidectomy Versus Myringotomy Plumentioning

confidence: 99%

“…38,[40][41][42][43][44][45][46][47]66,67 In 3 trials (4 articles) (all participants with adenoidectomy), 38,45,47,66 the risk of tympanosclerosis was higher with tubes than with myringotomy or no ear surgery (moderate SOE). Results for other harms were mixed, reported in single studies, or lacked precision (insufficient evidence).…”

Section: Tubes Plus Adenoidectomy Versus Myringotomy Plus Adenoidectomentioning

confidence: 99%

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Surgical Treatments for Otitis Media With Effusion: A Systematic Review

et al. 2014

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BACKGROUND AND OBJECTIVE: The near universality of otitis media with effusion (OME) in children makes a comparative review of treatment modalities important. This study' s objective was to compare the effectiveness of surgical strategies currently used for managing OME. METHODS:We identified 3 recent systematic reviews and searched 4 major electronic databases. Eligible studies included randomized controlled trials, nonrandomized trials, and cohort studies that compared myringotomy, adenoidectomy, tympanostomy tubes (tubes), and watchful waiting. Using established criteria, pairs of reviewers independently selected, extracted data, rated risk of bias, and graded strength of evidence of relevant studies. We incorporated meta-analyses from the earlier reviews and synthesized additional evidence qualitatively. RESULTS:We identified 41 unique studies through the earlier reviews and our independent searches. In comparison with watchful waiting or myringotomy (or both), tubes decreased time with OME and improved hearing; no specific tube type was superior. Adenoidectomy alone, as an adjunct to myringotomy, or combined with tubes, reduced OME and improved hearing in comparison with either myringotomy or watchful waiting. Tubes and watchful waiting did not differ in language, cognitive, or academic outcomes. Otorrhea and tympanosclerosis were more common in ears with tubes. Adenoidectomy increased the risk of postsurgical hemorrhage.CONCLUSIONS: Tubes and adenoidectomy reduce time with OME and improve hearing in the short-term. Both treatments have associated harms. Large, well-controlled studies could help resolve the riskbenefit ratio by measuring acute otitis media recurrence, functional outcomes, quality of life, and long-term outcomes. Research is needed to support treatment decisions in subpopulations, particularly in patients with comorbidities.

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Section: Comparative Benefits and Harms For Patient Subgroupsmentioning

confidence: 99%

Section: Tympanostomy Tubes Plus Adenoidectomy Versus Myringotomy Plumentioning

confidence: 99%

“…44 Harms of Treatments for OME Most studies examining surgical comparisons reported on harms. Table 5 provides the findings and SOE for harms by treatment comparisons.…”

Section: Tympanostomy Tubes Plus Adenoidectomy Versus Myringotomy Plumentioning

confidence: 99%

Section: Tubes Plus Adenoidectomy Versus Myringotomy Plus Adenoidectomentioning

confidence: 99%

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Surgical Treatments for Otitis Media With Effusion: A Systematic Review

et al. 2014

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“…We first screened the articles by title/abstract and excluded five trials in which all children underwent adenoidectomy. [31][32][33][34][35] An additional 467 studies were excluded for other reasons, for example follow-up for <12 months. In total, 31 articles were eligible for further assessment.…”

Section: Searchesmentioning

confidence: 99%