Otitis media with effusion and tubal tonsil (video).

Carbon dioxide laser surgery was performed on children aged 5 to 11 years, on whom either adenoidectomy or tonsilloadenoidectomy had been performed to restore their hearing. We examined 177 ears 18 to 24 months after surgery. Thirty ears (17%) were diagnosed as having otitis media with effusion. Analysis of the endoscopic findings revealed 51% marked tubal tonsil hypertrophy and 33% adenoid tissue hypertrophy. Subjects were operated upon in the dorsal position for a duration of point one second at an amplitude of 15 watts. Six months after surgery, most patients' hearing had returned to almost normal. The tympanograms which were taken 6 months after surgery showed good results in almost every case. Otitis media with effusion was found to have recurred in 3 ears. The effect of adenoidectomy is apparently dependent upon age, the size of adenoids, and the influence of allergies and sinusitis. Furthermore, our cases suggested that tubal tonsil hypertrophy was one of the factors found in recurrent otitis media with effusion in older children. It can thus be inferred that endoscopic examination of the postnasal space is recommended in children with recurrent otitis media with effusion after adenoidectomy, and that carbon dioxide laser surgery is a reliable therapeutic method in the topical treatment of this disease.