Surgical intervention for ineffective cases of conservatively managed otitis media with effusion in children

Objective To investigate the method and effect of surgical intervention for ineffective cases of conservatively managed otitis media with effusion(OME) in children.Methods 96 children(118 ears) suffering from chronic OME were conducted myringotomy with tube insertion,or myringotomy with tube insertion plus adenoidectomy under endoscope.Some of them received tonsillectomy due to chronic tonsillitis.All the patients were followed up more than half a year postoperatively,and the therapeutic effect was evaluated.Results Myringotomy tube insertion was conducted in 35 cases,myringotomy tube insertion combined with adenoidectomy in 49,myringotomy tube insertion combined with adenoidectomy plus tonsillectomy in 12 cases.The average air conduction hearing thresholds of speech frequency were(42 ± 5) dB,(34 ± 4) dB and(22 ± 2) dB respectively at the time points before operation,one week after operation and one month postoperatively.The symptoms including nasal obstruction,buccal respiration and snore at night were obviously relieved.Conclusions Surgical management for OME in children should be individualized,adenoidectomy and myringotomy tube insertion are basic surgical strategies for the ineffective pediatric cases with conservative treatment.