DOI: 10.4103/tjima.tjima_8_26 ISSN: 3050-6158

Effect of Adenotonsillectomy With or Without Ventilation Tubes for Chronic Adenotonsillitis Causing Otitis Media and Effusion: A Prospective Comparative Study

K. S. Aananda Krishna, Saai Ram Thejas
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Abstract

Background:

Nasopharyngeal tonsil hypertrophy and chronic adenotonsillitis in children are significant contributors to otitis media with effusion (OME), often resulting in conductive hearing loss. This study evaluates and compares the audiological outcomes of adenotonsillectomy with myringotomy alone versus adenotonsillectomy with myringotomy and ventilation tube (VT) insertion.

Materials and Methods:

A prospective, randomized, interventional study was conducted over 12 months at a rural tertiary care center. Ninety children (ages 6–15 years) diagnosed with bilateral OME were randomized into two groups: Group A ( n = 45) underwent adenotonsillectomy with bilateral myringotomy, and Group B ( n = 45) underwent the same with VT insertion. Preoperative and postoperative pure tone audiometry and impedance audiometry were compared at 3 months. Statistical analysis included paired and independent t tests and chi-square tests.

Results:

Demographic parameters were comparable between groups ( P > 0.05). Significant improvement in air-bone gap (ABG) was observed in both groups; however, Group B showed greater reduction (from 21.8 to 8.1 dB, P < 0.001) than in Group A (from 21.5 to 13.3 dB). Improvements in air and bone conduction thresholds were observed, but not statistically significant. Minor complications (otorrhea and tympanic membrane perforation) were slightly higher in Group B but not significantly so. Parental satisfaction and school attendance improved in both groups.

Conclusion:

While both surgical techniques improve hearing and quality of life, the addition of VT provides superior improvement in ABG. Given the minimal complication rate, VT insertion can be considered on a case-by-case basis in children undergoing adenotonsillectomy for OME.

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