Long Term Follow Up of Audiological Evaluation of Standalone Adenoidectomy versus Adenoidectomy with Grommet Insertion in Children with AOM with Effusion

Background: Acute Otitis media (AOM) is defined as an infection of the middle ear cleft and commonly seen as a pediatric emergency. AOM can occur at any age, but most frequently observed in children between 05 and 11 years. Nearly 80% of all children will experience minimum one incidence of AOM during their lifetime. Among them nearly 70% to 85% will have AOM with effusion before reaching the teen age. The present study was directed to reviews the epidemiology, etiology, evaluation, and management of AOM with effusion with an emphasis on the role of Adenoidectomy alone or in combination with Grommet insertion in its management. Aim of the Study: To study the epidemiology, etiology, evaluation, and management of AOM with effusion with an emphasis on the role of Adenoidectomy alone or in combination with Grommet insertion in its management. Materials: A prospective analytical study was conducted at Shadan Institute of Medical Sciences, Hyderabad to study the incidence, clinical signs and symptoms, final outcomes of treatment of AOM with Adenoidectomy alone (Group A) and Adenoidectomy in combination with Grommet insertion (Group B) in children over a period of 02 years. Mini AOM questionnaire containing AOM-10 Questionnaire which classified hearing loss, behavioral changes, school performance, sleep habits, and frequency of upper respiratory infections were used with 2 points for each of the queries graded on a Likert scale 1 to 10. Tympanic membrane findings were also graded as 3 categories- normal tympanic membrane, dull looking tympanic membrane with straw colored fluid with or without air bubbles in the middle ear, and Thick and grossly dull, retracted, or bulging, lusterless tympanic membrane. Data was analysed to compare and correlate the final outcome measured in terms of auditory gain and relief from symptoms using chi square and t test. Results: The demographic data showed a mean age of 8.3 ± 1.4 years in Group A and 7.3± 1.7 years for Group B. 59 male patients and 25 females in Group A and 57 children were males and 27 children were females in Group B were included. There was no statistical difference between the two groups in terms of age and gender. The statistical significance was indicated by a p-value of 0.0001. The mean auditory gain after 18 months in Group A children was 14.85±2.15 dB and in Group B it was 19.75±3.10 dB which was significant statistically with p value 0.001. Conclusions: Acute Otitis Media with effusion is a common entity and frequently reported in children and results in pain in the ear and loss of hearing. Eustachian tubal occlusion due to large adenoid masses was the true cause for AOM with effusion. Surgical treatment either with Adenoidectomy alone or in combination with Grommet insertion is the choicest management. Combined surgical treatment of Adenoidectomy and Grommet insertion demonstrated greater efficacy and statistically significant auditory gain when compared to Adenoidectomy alone.