Skip to main content
SpringerLink
Log in

Adenoidectomy and tympanostomy tubes in the management of otitis media

  • Published:
Current Allergy and Asthma Reports Aims and scope Submit manuscript

Abstract

Otitis media is one of the most common childhood infections and the most frequent cause for antibiotic prescriptions in children. As respiratory infections are also associated with childhood asthma, children with recurrent otitis media or with persistent middle-ear effusion are also at an increased risk for developing asthma, which should be appreciated when a child with middle-ear disease is evaluated. The .rst choice of surgery in chronic middle-ear inflammatory disease is the insertion of tympanostomy tubes. It is warranted when the middle-ear effusion has lasted for 3 or more months. When chronic adenoid infection is suspected, adenoidectomy may be beneficial in treating otitis media in children who are older than 4 years of age and who have previously undergone tympanostomy-tube insertion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Teele DW, Klein JO, Rosner B: Epidemiology of otitis media during the.rst seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989, 160:83–94.

    PubMed  CAS  Google Scholar 

  2. Paradise JL, Rockette HE, Colborn DK, et al.: Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the.rst two years of life. Pediatrics 1997, 99:318–333. This is a thorough investigation of the epidemiology of childhood otitis media.

    Article  PubMed  CAS  Google Scholar 

  3. Lanphear BP, Byrd RS, Auinger P, Hall CB: Increasing prevalence of recurrent otitis media among children in the United States. Pediatrics 1997, 99:E1.

    Article  PubMed  CAS  Google Scholar 

  4. Joki-Erkkilä VP, Laippala P, Pukander J: Increase in paediatric acute otitis media diagnosed by primary care in two Finnish municipalities—1994–1995 versus 1978–1979. Epidemiol Infect 1998, 121:529–534.

    Article  PubMed  Google Scholar 

  5. Heikkinen T, Chonmaitree T: Importance of respiratory viruses in acute otitis media. Clin Microbiol Rev 2003, 16:230–241. This is a review of the pathogenesis of otitis media and the role of viruses in triggering a bacterial otitis media.

    Article  PubMed  Google Scholar 

  6. Cundell DR, Gerard NP, Gerard C, et al.: Streptococcus pneumoniae anchor to activated human cells by the receptor for platelet-activating factor. Nature 1995, 377:435–438.

    Article  PubMed  CAS  Google Scholar 

  7. Kilpi T, Herva E, Kaijalainen T, et al.: Bacteriology of acute otitis media in a cohort of Finnish children followed for the.rst two years of life. Pediatr Infect Dis J 2001, 20:654–662.

    Article  PubMed  CAS  Google Scholar 

  8. Salonen EM, Vaheri A, Meri S, et al.: Plasmin and.bronectin degradation in chronic secretory otitis media. Arch Otolaryngol Head Neck Surg 1989, 115:48–53.

    PubMed  CAS  Google Scholar 

  9. Heikkinen T, Ghaffar F, Okorodudu AO, Chonmaitree T:Serum interleukin-6 in bacterial and nonbacterial acute otitis media. Pediatrics 1998, 102:296–299.

    Article  PubMed  CAS  Google Scholar 

  10. Leibovitz E, Dagan R, Laver JH, et al.: Interleukin 8 in middle ear.uid during acute otitis media: correlation with aetiology and bacterial eradication. Arch Dis Child 2000, 82:165–168.

    Article  PubMed  CAS  Google Scholar 

  11. Storgaard M, Larsen K, Blegvad S, et al.: Interleukin-8 and chemotactic activity of middle ear effusions. J Infect Dis 1997, 175:474–477.

    PubMed  CAS  Google Scholar 

  12. Rapola S, Jäntti V, Haikala R, et al.: Natural development of antibodies to pneumococcal surface protein A, pneumococcal surface adhesin A, and pneumolysin in relation to pneumococcal carriage and acute otitis media. J Infect Dis 2000, 182:1146–1152.

    Article  PubMed  CAS  Google Scholar 

  13. Fergie N, Bayston R, Pearson JP, Birchall JP: Is otitis media with effusion a biofilm infection? Clin Otolaryngol Allied Sci 2004, 29:38–46. This is a thorough review of the role of biofilms in otitis media.

    Article  PubMed  CAS  Google Scholar 

  14. Uhari M, Mäntysaari K, Niemelä M: A meta-analytic review of the risk factors for acute otitis media. Clin Infect Dis 1996, 22:1079–1083.

    PubMed  CAS  Google Scholar 

  15. Casselbrant ML, Mandel EM, Fall PA, et al.: The heritability of otitis media: a twin and triplet study. JAMA 1999, 282:2125–2130.

    Article  PubMed  CAS  Google Scholar 

  16. Kvaerner KJ, Tambs K, Harris JR, Magnus P: Distribution and heritability of recurrent ear infections. Ann Otol Rhinol Laryngol 1997, 106:624–632.

    PubMed  CAS  Google Scholar 

  17. Rovers M, Haggard M, Gannon M, et al.: Heritability of symptom domains in otitis media: a longitudinal study of 1373 twin pairs. Am J Epidemiol 2002, 155:958–964.

    Article  PubMed  Google Scholar 

  18. Daly KA, Brown WM, Segade F, et al.: Chronic and recurrent otitis media: a genome scan for susceptibility loci. Am J Hum Genet 2004, 75:988–997.

    Article  PubMed  CAS  Google Scholar 

  19. Juntti H, Tikkanen S, Kokkonen J, et al.: Cow’s milk allergy is associated with recurrent otitis media during childhood. Acta Otolaryngol 1999, 119:867–873.

    Article  PubMed  CAS  Google Scholar 

  20. Fireman P: Otitis media and eustachian tube dysfunction: connection to allergic rhinitis. J Allergy Clin Immunol 1997, 99:S787-S797.

    PubMed  CAS  Google Scholar 

  21. Tasker A, Dettmar PW, Panetti M, et al.: Reflux of gastric juice and glue ear in children. Lancet 2002, 359:9.

    Article  Google Scholar 

  22. Paradise JL, Elster BA, Tan L: Evidence in infants with cleft palate that breast milk protects against otitis media. Pediatrics 1994, 94:853–860.

    PubMed  CAS  Google Scholar 

  23. Kangsanarak J, Fooanant S, Ruckphaopunt K, et al.:Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases. J Laryngol Otol 1993, 107:999–1004.

    PubMed  CAS  Google Scholar 

  24. Kvestad E, Kvaerner KJ, Mair IW: Otologic facial palsy: etiology, onset, and symptom duration. Ann Otol Rhinol Laryngol 2002, 111:598–602.

    PubMed  Google Scholar 

  25. Oestreicher-Kedem Y, Raveh E, Kornreich L, et al.: Complications of mastoiditis in children at the onset of a new millennium. Ann Otol Rhinol Laryngol 2005, 114:147–152.

    PubMed  Google Scholar 

  26. Ooi EH, Hilton M, Hunter G: Management of lateral sinus thrombosis: update and literature review. J Laryngol Otol 2003, 117:932–939.

    Article  PubMed  Google Scholar 

  27. Lieberthal AS, Ganiatis TG, Cox EO, et al.: American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guideline. Subcommittee on Management of Acute Otitis Media. Diagnosis and Management of Acute Otitis Media. Pediatrics 2004, 113:1451–1465. This is a guideline on the management of otitis media with effusion in young children.

    Article  Google Scholar 

  28. American Academy of Pediatrics: Guideline: Managing otitis media with effusion in young children. The Otitis Media Guideline Panel.Pediatrics 1994, 94:766–773.

  29. Casselbrant ML, Kaleida PH, Rockette HE, et al.: Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media: results of a randomized clinical trial. Pediatr Inf Dis J 1992, 11:278–286.

    Article  CAS  Google Scholar 

  30. Paradise JL, Dollaghan CA, Campbell TF, et al.: Otitis media and tympanostomy tube insertion during the.rst three years of life: developmental outcomes at the age of four years. Pediatrics 2003, 112:265–277.

    Article  PubMed  Google Scholar 

  31. Johnston LC, Feldman HM, Paradise JL, et al.: Tympanic membrane abnormalities and hearing levels at the ages of 5 and 6 years in relation to persistent otitis media and tympanostomy tube insertion in the.rst 3 years of life: a prospective study incorporating a randomized clinical trial. Pediatrics 2004, 114:e58-e67.

    Article  PubMed  Google Scholar 

  32. Derkay CS, Carron JD, Wiatrak BJ, et al.: Postsurgical follow- up of children with tympanostomy tubes: results of the American Academy of Otolaryngology-Head and Neck Surgery Pediatric Otolaryngology Committee National Survey. Otolaryngol Head Neck 2000, 122:313–318.

    Article  CAS  Google Scholar 

  33. Bienenstock J, McDermott MR: Bronchus- and nasal-associated lymphoid tissues. Immunol Rev 2005, 206:22–31.

    Article  PubMed  Google Scholar 

  34. Vogler RC, Wippold FJ 2nd, Pilgram TK: Age-specific size of the normal adenoid pad on magnetic resonance imaging. Clin Otolaryngol 2000, 25:392–395.

    Article  PubMed  CAS  Google Scholar 

  35. Pajusto M, Tarkkanen J, Mattila PS: Platelet endothelial cell adhesion molecule-1 is expressed in adenoidal crypt epithelial cells. Scand J Immunol 2005, 61:82–86.

    Article  PubMed  CAS  Google Scholar 

  36. Pajusto M, Ihalainen N, Pelkonen J, et al.: Human in vivo-activated CD45R0(+) CD4(+) T cells are susceptible to spontaneous apoptosis that can be inhibited by the chemokine CXCL12 and IL-2, -6, -7, and -15. Eur J Immunol 2004, 34:2771–2780.

    Article  PubMed  CAS  Google Scholar 

  37. Pajusto M, Toivonen TH, Tarkkanen J, et al.: Reactive oxygen species induce signals that lead to apoptotic DNA degradation in primary CD4+ T cells. Apoptosis 2005, 10:1433–1443.

    Article  PubMed  CAS  Google Scholar 

  38. Pajusto M, Tarkkanen J, Mattila PS: Human primary adenotonsillar naive phenotype CD45RA CD4 T lymphocytes undergo apoptosis upon stimulation with a high concentration of CD3 antibody. Scand J Immunol 2005, 62:546–551.

    Article  PubMed  CAS  Google Scholar 

  39. Gates GA: Otitis media-the pharyngeal connection. JAMA 1999, 282:987–989.

    Article  PubMed  CAS  Google Scholar 

  40. Goldstein NA, Fatima M, Campbell TF, Rosenfeld RM:Child behavior and quality of life before and after tonsillectomy and adenoidectomy. Arch Otolaryngol Head Neck Surg 2002, 128:770–775.

    PubMed  Google Scholar 

  41. Paradise JL, Bluestone CD, Rogers KD, et al.: Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement. Results of parallel randomized and nonrandomized trials. JAMA 1990, 263:2066–2073.

    Article  PubMed  CAS  Google Scholar 

  42. Gates GA, Avery CA, Prihoda TJ, Cooper JC Jr: Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion. N Engl J Med 1987, 317:1444–1451.

    Article  PubMed  CAS  Google Scholar 

  43. Maw R, Bawden R: Spontaneous resolution of severe chronic glue ear in children and the effect of adenoidectomy, tonsillectomy, and insertion of ventilation tubes (grommets). Br Med J 1993, 306:756–760.

    Article  CAS  Google Scholar 

  44. Mattila PS, Joki-Erkkilä VP, Kilpi T, et al.: Prevention of otitis media by adenoidectomy in children younger than 2 years. Arch Otolaryngol Head Neck Surg 2003, 129:163–168.

    Article  PubMed  Google Scholar 

  45. Koivunen P, Uhari M, Luotonen J, et al.: Adenoidectomy versus chemoprophylaxis and placebo for recurrent acute otitis media in children aged under 2 years: randomised controlled trial. Br Med J 2004, 328:487.

    Article  Google Scholar 

  46. Hammaren-Malmi S, Saxen H, Tarkkanen J, Mattila PS: Adenoidectomy does not significantly reduce the incidence of otitis media in conjunction with the insertion of tympanostomy tubes in children who are younger than 4 years: a randomized trial. Pediatrics 2005, 116:185–189. This is an extensive survey on the Efficacy of adenotonsillar surgery in acute otitis media.

    Article  PubMed  Google Scholar 

  47. Paradise JL, Bluestone CD, Colborn DK, et al.: Adenoidectomy and adenotonsillectomy for recurrent acute otitis media: parallel randomized clinical trials in children not previously treated with tympanostomy tubes. JAMA 1999, 282:945–953.

    Article  PubMed  CAS  Google Scholar 

  48. Coyte PC, Croxford R, McIsaac W, et al.: The role of adjuvant adenoidectomy and tonsillectomy in the outcome of the insertion of tympanostomy tubes. N Engl J Med 2001, 344:1188–1195.

    Article  PubMed  CAS  Google Scholar 

  49. Mattila PS, Hammaren-Malmi S, Tarkkanen J, et al.:Adenoidectomy during early life and the risk of asthma. Pediatr Allergy Immunol 2003, 14:358–362.

    Article  PubMed  Google Scholar 

  50. Nafstad P, Brunekreef B, Skrondal A, Nystad W: Early respiratory infections, asthma, and allergy: 10-year follow-up of the Oslo Birth Cohort. Pediatrics 2005, 116:e255-e262.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Helsinki University Central Hospital, PO Box 220, 00290, Helsinki, Finland

    Petri S. Mattila MD, PhD

Authors
  1. Petri S. Mattila MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mattila, P.S. Adenoidectomy and tympanostomy tubes in the management of otitis media. Curr Allergy Asthma Rep 6, 321–326 (2006). https://doi.org/10.1007/s11882-006-0067-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11882-006-0067-7

Keywords

Search

Navigation