International journal of pediatric otorhinolaryngology · 2026
Adenoidectomy with tympanostomy or with myringotomy alone: A systematic review of pediatric randomized controlled trials.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Albazee Ebraheem, Albannai Noof, Alismail Hajar, Alazemi Yasmeen, Alsaeed Munawer, Alhammadi Esraa, Awadh Abrar, Alabdullah Abdullah, AlRaish Mariam, Alawadhi Ahmad, Aldawas Ghezlan, Alkaak Mohmmad, Ismaeel Dhoha
Аннотация
BACKGROUND: Otitis media with effusion (OME) is a leading cause of acquired conductive hearing loss in children. When performing an adenoidectomy for OME, surgeons must decide whether to supplement the procedure with a simple myringotomy or a myringotomy with tympanostomy tube (TT) insertion. While TT offers extended middle ear ventilation, it carries a risk of long-term complications. This systematic review of randomized controlled trials (RCTs) aimed to compare the efficacy and safety of these two approaches.
METHODS: A comprehensive search of PubMed, Scopus, CENTRAL, and Web of Science was conducted for RCTs up to August 2025. Eligible RCTs were assessed for quality using the risk of bias (RoB)-2 tool. The primary outcomes were hearing improvement and resolution of effusion. Secondary outcomes included OME recurrence and postoperative complications.
RESULTS: Eleven RCTs involving 955 pediatric patients were included. The addition of TT consistently resulted in superior short-term outcomes, with significantly better hearing levels and faster resolution of middle ear effusion within the first 3-6 months. However, these advantages were not sustained, and no significant differences in hearing or effusion rates were observed at 12-month follow-ups. In contrast, the TT group experienced a significantly higher incidence of long-term complications, including otorrhea, tympanosclerosis, and persistent tympanic membrane perforation.
CONCLUSION: Adding a TT to adenoidectomy provides a transient benefit in hearing and effusion resolution but significantly increases the risk of long-term tympanic membrane complications. Adenoidectomy with myringotomy alone appears to be a safer and equally effective long-term strategy for managing pediatric OME.
METHODS: A comprehensive search of PubMed, Scopus, CENTRAL, and Web of Science was conducted for RCTs up to August 2025. Eligible RCTs were assessed for quality using the risk of bias (RoB)-2 tool. The primary outcomes were hearing improvement and resolution of effusion. Secondary outcomes included OME recurrence and postoperative complications.
RESULTS: Eleven RCTs involving 955 pediatric patients were included. The addition of TT consistently resulted in superior short-term outcomes, with significantly better hearing levels and faster resolution of middle ear effusion within the first 3-6 months. However, these advantages were not sustained, and no significant differences in hearing or effusion rates were observed at 12-month follow-ups. In contrast, the TT group experienced a significantly higher incidence of long-term complications, including otorrhea, tympanosclerosis, and persistent tympanic membrane perforation.
CONCLUSION: Adding a TT to adenoidectomy provides a transient benefit in hearing and effusion resolution but significantly increases the risk of long-term tympanic membrane complications. Adenoidectomy with myringotomy alone appears to be a safer and equally effective long-term strategy for managing pediatric OME.