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Treatment of glue ear in relation to radiographic palatal airway size: a predictor for outcome following adenoidectomy?

Published online by Cambridge University Press:  29 June 2007

Andrew J. Parker*
Affiliation:
Research Fellow and Hononary Registrar, Clinical Lecturer and Head of Department, The Department of Otolaryngology, Bristol Royal Infirmary, Bristol BS2 8HW.
A. Richard Maw
Affiliation:
Consultant Surgeon, Clinical Lecturer and Head of Department, The Department of Otolaryngology, Bristol Royal Infirmary, Bristol BS2 8HW.
*
Mr A. J. Parker, The Department of Otolaryngology, The Royal Hallamshire Hospital, Sheffield S10 2JF, South Yorkshire.

Abstract

Adenoidectomy performed for ‘glue ear’ accounts for many of the admissions for surgery in childhood. In spite of this there are no objective guidelines to enable the clinician to select those cases in whom a definite benefit is likely, or in whom such procedures might best be avoided. A total of 147 children with established bilateral glue ear randomized to adenoidectomy (A) or no pharyngeal surgery (NS) treatment groups were examined for clearance of effusion in an unoperated ear after one year. Outcome was analysed with respect to the pre-operative Radiographic Palatal Airway size in three groups in relation to mean measurements obtained from matched populations of normal children and those with established disease. Those with small airways had significantly increased clearance following A when compared with NS between the ages of 3–7 years. Adenoidectomy should probably not be performed in those children with large airway measurements, although the outcome may ultimately be related to the age at which surgery is performed.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1989

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References

Ballantyne, J. C. (1976) Adenoidectomy. In Operative Surgery, (Rob, C. and Smith, R. eds.) p. 134Butterworths, London.Google Scholar
Black, N. A. (1984) Surgery for glue ear—a modern epidemic. Lancet, 1: 835837.CrossRefGoogle ScholarPubMed
Grandy, C. C. (1925) Roentgenographic demonstration of adenoids. American Journal of Roentgenology, 14: 114117.Google Scholar
Hibbert, J. (1977) The current status of adenoidectomy: a survey amongst otolaryngologists. Clinical Otolaryngology, 2: 239247.Google Scholar
Hibbert, J. and Stell, P. M. (1979) A radiological study of the adenoid in normal children. Clinical Otolaryngology, 4: 321327.Google Scholar
Jeans, W. D., Fernando, D. C. J. and Maw, A. R. (1981a) How should adenoidal enlargement be measured? A radiological study based on inter-observer agreement. Clinical Radiology, 32: 337340.CrossRefGoogle Scholar
Jeans, W. D., Fernando, D. C.J., Maw, A. R. and Leighton, B. C. (1981b) A longitudinal study of the growth of the nasopharynx and its contents in normal children. British Journal of Radiology, 54: 117121.Google Scholar
Linder-Aronson, S. and Leighton, B. C. (1983) A longitudinal study of the development of the posterior nasopharyngeal wall between 3 and 18 years of age. European Journal of Orthodontics, 5: 4758.CrossRefGoogle Scholar
McKee, W. J. E. (1973) A controlled study of the effects of tonsillectomy and adenoidectomy in children. British Journal of Preventive and Social Medicine, 17: 4969.Google Scholar
Maw, A. R., Jeans, W. D. and Fernando, D. C. J. (1981) Interobserver variability in the clinical and radiological assessment of adenoid size, and the correlation with adenoid volume. Clinical Otolaryngology, 6: 317322.Google Scholar
Maw, A. R. and Herod, F. (1986) Otoscopic, impedance and audiometric findings in glue ear treated by adenoidectomy and tonsillectomy: a prospective randomised study. Lancet, 1: 13991402.Google Scholar
Mawson, S. R. (1979) Diseases of the tonsils and adenoids. In Scott-Brown's Diseases of the Ear Nose and Throat (Ballantyne, J. and Groves, J. eds.) Butterworths London (4th ed.) Vol. 4, 95170.Google Scholar
Phillips, D. E., Maw, A. R. and Harvey, K. (1987) The nasopharynx and adenoid in children with glue ear compared with normal controls. Clinical Otolaryngology, 12: 255260.Google Scholar
Roydhouse, N. (1970) A controlled study of adenotonsillectomy. Archives of Otolaryngology, 92: 611616.Google Scholar
Sade, J. (1979) Secretory otitis media and its sequelae. Churchill Livingstone, London; p.268.Google Scholar
Slack, R. W. T., Maw, A. R., Capper, J. W. R. and Kelly, S. (1984) A prospective study of tympanosclerosis developing after grommet insertion,. Journal of Laryngology and Otology, 98: 771774.CrossRefGoogle ScholarPubMed
Stell, P. M. (1981) Adenoidectomy. Clinical Otolaryngology, 6: 13.Google Scholar