삼출성 중이염의 재발 방지에 있어 아데노이드 절제술의 효과와 예후 인자
Efficacy of Adenoidectomy in Preventing Recurrence of Otitis Media with Effusion
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Abstract
Background and Objectives：Previous studies of the eficacy of adenoidectomy in otitis media with efusion have yielded conflicting results. The aim of this study was to investigate the efficacy of adenoidectomy and influences of other asociated risk factors on the recurrence of otitis media with efusion (OME). Subjects and Method : A retrospective analysis was carried out on 441 ears of 266 patients who underwent tympanostomy tube (T-tube) insertions from January 1990 to December 2000. according to the surgical procedures they underwent; T-tube insertion only, T-tube insertion and ade-noidectomy and T-tube insertion and adenotonsillectomy. In addition to the type of surgical procedure, the time elapsed to the extrusion of T-tube, age, paranasal sinusitis, the nature of effusion, and adenoid size were chosen as factors affecting the recurrence of otitis media with efusion. The recurrence of OME, the reinsertion of T-tube, and the number of T-tube insertions during each patients follow-up period were defined as the dependent variables. Statistical analyses were performed by multiple logistic Results : A significant benefit was observed with adenoidectomy in preventing recurrence of OME (p<0.001), which was not enhanced by tonsillectomy. The effect of adenoidectomy was independent of adenoid size. Earlier extrusion of tympanostomy tubes was strongly correlated with the recurrence of otitis media with efusion (p<0.0001). OME tended to recur if the patients had younger age. Conclusion : Performing adenoidectomy at the d of reinsertion of T-tube.
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