Hancock Sarah, Allen Paul, Dixon Angel'Niqua, Faria John, Vandjelovic Nathan, McKenna Benoit Margo
University of Rochester School of Medicine and Dentistry, Rochester, NY 601 Elmwood Avenue, Rochester, NY, 14642, United States.
University of Rochester Department of Otolaryngology Head and Neck Surgery, Rochester, NY 601 Elmwood Avenue, Rochester, NY, 14642, United States.
Int J Pediatr Otorhinolaryngol. 2022 Jun;157:111130. doi: 10.1016/j.ijporl.2022.111130. Epub 2022 Apr 11.
To determine whether removing or retaining adenoids at the time of placement of a second set of ear tubes impacts the need for a third set of ear tubes later in childhood.
Single-institution retrospective case series.
Tertiary academic university hospital.
We identified pediatric subjects who had undergone a second ear tube placement between 1/1/17 and 9/1/19. Subjects were stratified into two groups: 1) adenoids removed at time of second tympanostomy tube insertion (TT+A) and 2) adenoids retained at time of second tympanostomy tube insertion (TT-A). A subset of children less than age 4 was also studied independently. The primary outcome was number of patients requiring a third set of tympanostomy tubes.
A total of 136 subjects met inclusion and exclusion criteria. Among children less than 4 years of age (n = 99), the incidence of requiring a third set of tubes was significantly lower in the TT+A group <4 (12.8%; 6/47) compared to the TT-A group <4 (44.2%; 23/52) (p = 0.0008) with an odds ratio of 0.18 (95%CI 0.067-0.51) and number needed to treat of 3.2.
Performing adenoidectomy in children less than 4 years of age at the second tympanostomy procedure was associated with a reduced incidence of requiring a third set of ear tubes.
确定在植入第二组耳管时切除或保留腺样体是否会影响儿童后期对第三组耳管的需求。
单机构回顾性病例系列研究。
三级学术大学医院。
我们确定了在2017年1月1日至2019年9月1日期间接受第二次耳管植入的儿科患者。将患者分为两组：1）在第二次鼓膜置管术时切除腺样体（TT+A）和2）在第二次鼓膜置管术时保留腺样体（TT-A）。还对一组年龄小于4岁的儿童进行了独立研究。主要结局是需要第三组鼓膜置管的患者数量。
共有136名受试者符合纳入和排除标准。在年龄小于4岁的儿童中（n = 99），TT+A组<4岁（12.8%；6/47）需要第三组耳管的发生率显著低于TT-A组<4岁（44.2%；23/52）（p = 0.0008），优势比为0.18（95%CI 0.067 - 0.51），治疗所需人数为3.2。
在第二次鼓膜置管手术时对年龄小于4岁的儿童进行腺样体切除术与需要第三组耳管的发生率降低相关。
