Does an Adenoidectomy with a Second Set of Tympanostomy Tubes Reduce Subsequent Tube Placements?

Introduction: Adenoidectomy can be combined with tympanostomy tube (TT) placement in patients with middle ear disease to reduce the risk of additional TT. This study evaluates outcomes of children undergoing adenoidectomy (with/without tonsillectomy) during second TT placement compared to those undergoing TT placement alone; these outcomes were used to assess the likelihood of needing a third set. This study also examines if adenoid pad obstruction correlates with reduced need for a third set.

Methods: A retrospective chart review was done of patients ages 1-17 that had two sets of TT from January 2018-June 2024 with diagnoses of otitis media, suppurative otitis media, nasal obstruction, mouth breathing, adenoid hypertrophy, hyponasal speech, obstructive sleep apnea, or snoring. Craniofacial abnormalities were excluded. Other data included was adenoidectomy with/without tonsillectomy as well as if patients received a third set of TT. Demographics were collected. Fisher’s exact test and Student’s t-test were used to compare, respectively, the percentage of patients receiving a third set of TT across different procedure groups and percentage of adenoid obstruction between patients with and without a third set.

Results: There is ongoing extraction of data. 84 children met the inclusion criteria. In patients who did not undergo adenoidectomy, 21.3% received a third set. In comparison, children who underwent adenoidectomy alone, 26.7% received a third set and in children who received a T&A, 22.2% received a third set (p=0.91). This study found that patients who received an adenoidectomy with their second set of TT who did not receive a third set had an average of 70% obstruction, whereas patients that did have a third set had an average of 55% obstruction (p=0.34).

Conclusions: There was no significant difference in the likelihood of requiring a third set of TT between children who underwent adenoidectomy during their second tube placement and those who did not. Although no statistically significant association was found with adenoid obstruction, a larger study is needed to further investigate this correlation.