• Comparative effectiveness of the methods adenoidectomy in children with exudative otitis media 

Comparative effectiveness of the methods adenoidectomy in children with exudative otitis media 

SOVREMENNAYA PEDIATRIYA.2016.2(74):151-154; doi 10.15574/SP.2016.74.151 

Comparative effectiveness of the methods adenoidectomy in children with exudative otitis media 

Gusakov A., Zheltov A., Kokorkin D.

Zaporozhye Medical Academy of Postgraduate Education of Ukraine 

Actuality: A thorough sanation of the nasopharynx is essential for successful treatment of the exudative otitis media (EOM). The literature describes in detail the state of the nasopharynx after different types of adenoidectomy. The classifications of the location of the remnants of lymphoid tissue and the extent of scarring in the nasopharynx are given.The subject of this work is to trace the relationship of postoperative nasopharyngeal changes with recurrent EOM.

Objective: To study the immediate and long-term results of different methods of surgical treatment of hypertrophy of the nasopharyngeal lymphoid tissue in children with exudative otitis media. 

Materials and Methods: This paper presents information on the results of treatment of 62 children of 5–7 years suffering from exudative otitis media. Observations were carried out in two groups of patients. The first group included 28 children previously undergone adenoidectomy, with the signs of recurrent exudative otitis. The second group included 34 children with exudative otitis previously untreated surgically. The task of the investigation is to study the effectiveness of endonasal and extranasal methods of surgical removal of nasopharengeal lymphoid tissue with a minimum probability of scar obliteration of the mouth of the Eustachian tube. 

Results and discussion: The priority method in nasopharengeal surgery in children is extranasal access with shaver technology in conjunction with cold plasma surgery. The using of these methods gives a clear visualization of the operating field under conditions of moderately bleeding wound. On the other hand, endonasal approach is associated with traumatization of the nasal mucosa with incomplete volume visualization of the surgical field. This combination can result in a longer healing of the surgical wound, the formation of adhesions of the nasal cavity and scarring in the nasopharynx. Complete visualization of the operating field significantly affects the long-term results of EOM treatment in childhood. 

Conclusions: The use of cold plasma surgery combined with shaver gives the possibility to achieve in the long term a stable cure in 93% of children with exudative otitis media with minimal (less than 6%) traumatic changes in the nasopharynx. 

Keywords: adenoidectomy, exudative otitis media, children. 

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