From: anonymous@mail.island.net
Subject: adnoid removal
Posted-By: xx108 (ENT Clinic Moderator)
Organization: Organization For Community Networks
Date: Tue, 29 Apr 1997 13:10:34 -0700
Newsgroups: ofcn.clinic.ent

My son is 6 and a half years old he has had chronic ear infections since infancy. He has had two sets of tubes in. The last set of tubes fell out in January of this year he has had an ear infection ever since. He has been on three different types of antibiotics in four months and his infection is not going away. Our ear doctor has recomended that he has a third set of tubes put in. I asked about removal of the adnoid and he didn't feel that it would make any difference at this time. I'm quite concerned about my son being on medication for such a long period of time his amune system is so low. I've been told that this was nothing to be concerned about. His ear infections seem to be getting worse not better he has them more often.
Would you recommened the removal of a childs adnoids for chronic ear infections? Do your tubes actualy get bigger, or change with age or does your adnoids shrink and disapper with age therefor opening up your tubes.

Reply: -------------------------

Clinical research has demonstrated that in children older than 4 years of age who have chronic otitis media which fails medical therapy, and particularly when there is middle ear fluid present for 3 months or longer,there is significant potential benefit from adenoidectomy combined with tympanostomy tube insertion. Furthermore, it has been shown that the benefit of adenoidectomy in this situation is the same regardless of the size of the adenoids. In other words, enlarged adenoids such as that which causes mouthbreathing or snoring need not be present to consider adenoidectomy potentially beneficial in the treatment of chronic otitis media. The theory is that the adenoids, large or small, may be colonized with bacteria which is never completely eradicated by antibiotic therapy with the bacteria refluxing up the eustachian tube thereby causing otitis. As to your latter question, the adenoids due indeed atrophy with age, but typically this will not occur until the late teenage years.

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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis

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