Table 34Treatment harms: Adenoidectomy versus other interventions

StudyArm (N)Study Duration Until Outcome MeasurementRepeat Tubes/Treatment FailureOtorrhea, PerforationTympanosclerosis/Other Harms
RCT: Paradise et al., 199074aG1: Adenoidectomy
G2: No treatment (N=99)
Of 125 who received adenoidectomy, none developed anesthetic complications
Mean # of TT/subject (range) procedure
Year 1
G1: 0.13 (0–1)
G2: 0.29 (0–1)

Year 2
G1: 0.13 (0–2)
G2: 0.26 (0–2)

Year 3
G1: 0.08 (0–1)
G2: 0.13 (0–1)
Otorrhea, Mean #/subject (range)
Year 1
G1: 0.13 (0–1)
G2: 0.13 (0–2)

Year 2
G1: 0.09 (0–1)
G2: 0.14 (0–1)

Year 3
G1: 0.05 (0–1)
G2: 0.07 (0–1)
RCT: Casselbrant et al., 2009119G1: Adenoidectomy+ myr + bilateral TT
G2: Myr + bilateral TT
(18 mos: N=44)
(36 mos: N=39)
Otorrhea,1 or more episodes:
0–18 mos:
G1: 41%
G2:36%
Diff G1 vs. G2:
p = 0.59

0–36 mos:
G1: 47%
G2:45%
Diff G1 vs. G2:
p = 0.59
RCT: Gates et al., 198795

Companion
Gates et al., 1989102
G1: Myr
(N=107)
G2: Bilateral Shepard TT (N=129)
G3: Adenoidectomy + Myr
(N=130)
G4: Adenoidectomy + Bilateral Shepard TT
(N=125)
Surgical retreatments:
G1: 46%
G2: 24%
G3: 12%
G4: 11%
p = 0.001
Otorrhea, 1 or more episodes:
G1: 22%
G2: 29%
G3: 19%
G4: 24%
p = 0.009
1 patient bled after adenoidectomy surgery, no other adenoidectomy complications, no deaths
MRC TARGET, 201219G1: Adenoidectomy + Myr + Bilateral Shepard TT
G2: Myr + bilateral Shepard TT
G3: WW
(N = 376)
Perforation
5 of 635 ears may have lasting perforations, based on observed followup.
Tympanosclerosis
20% in operated ears vs. 0% in unoperated

Other, hemorrhage
1 adenoidectomy post-operative hemorrhage (0.6%)

G = group; Myr = myringotomy; mos = months; NRCT = nonrandomized controlled trial; RCT = randomized controlled trial; TARGET = Trial of Alternative Regimens in Glue Ear Treatment; TT = tympanostomy tubes; vs. = versus; WW = watchful waiting

From: Results

Cover of Otitis Media With Effusion: Comparative Effectiveness of Treatments
Otitis Media With Effusion: Comparative Effectiveness of Treatments [Internet].
Comparative Effectiveness Reviews, No. 101.
Berkman ND, Wallace IF, Steiner MJ, et al.

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