THE EFFECT OF EARLY ADENOIDECTOMY ON
NASAL CAVITY VOLUME AND UPPER DENTAL
ARCH DIMENSIONS IN CHILDREN WITH
RECURRENT MIDDLE EAR INFECTION
1
P,
2
J,
2
M,
3
M,
4
T
Niemi
Numminen
Rautiainen
Helminen
Peltomäki
¹Department of Maxillofacial Surgery and Oral Diseases, Satakunta Central Hospital, 2Department of
3
Otorhinolaryngology, Tampere University Hospital, Science center, Pirkanmaa Hospital District and School of Health
Sciences, University of Tampere and ⁴Oral and Maxillofacial Unit, Tampere University Hospital, Finland
AIM.
The aim of the study was to examine the effect of adenoidectomy on occlusal
development and nasal cavity volume in children who underwent tympanostomy tube
insertion with or without adenoidectomy due to recurrent episodes of middle ear infection.
HYPOTHESIS. It is hypothesized that children with tympanostomy
tube insertion with adenoidectomy have more optimal occlusal
development than children with tympanostomy tube insertion alone.
MATERIALS AND METHODS. Material consisted of children
(<2 years) who had more than 3-5 events of middle ear infections
during the last 6 months or 4-6 events during the last year. All were
diagnosed at the Department of Otorhinolaryngology, Tampere
University Hospital, Finland. The children were randomly allocated to
one of the two treatment groups: tympanostomy tube placement
without adenoidectomy (Group 1, n=63) or tympanostomy tube
placement with adenoidectomy (Group 2, n=74). An informed consent
was obtained from parents of all children.
At 5 years the children were re-examined. Group 1 comprised of 41
children (14 females, 27 males, mean age 5.2 yrs, SD 0.17) and Group
2 59 children (17 females, 42 males, mean age 5.2 yrs, SD 0.18). At
this time otorhinolaryngologist and orthodontist made clinical
examination including acoustic rhinometry and rhinomanometry to
measure nasal cavity geometry and airway resistance and occlusal bite
index to measure upper dental arch transversal and sagittal
dimensions. The differences between measurements in the two
treatment groups were tested with t-test and Kruskal-Wallis test.
RESULTS.
There were no statistically significant differences
between the groups in the nasal or upper dental arch
measurements. Inter-canine width between upper primary
canines (dd. 53-63) was 28.3 mm in both groups, inter-molar
width between mesio-palatal cusps of upper second primary
molars (dd. 55-65) were 34.1mm and 34.0mm and arch length
from labial surfaces of the first primary incisors perpendicular to
the line parallel connecting the distal surfaces of the upper
secondary primary molars were 28.5mm and 28.4 mm in the
Groups 1 and 2, respectively.
Eligible patients (n=137)
• Children (<2 yrs) more than 3-5
events of middle ear infection during
the last 6 months or 4-6 events during
the last year
Randomization
Group 1
Tympanostomy
n=63
Orthodontic
and ENT
examination
n=41
14♀, 27 ♂
Mean age 5.2 yrs
Orthodontic
and ENT
examination
n=59
17♀, 42 ♂
Dental arch measurements (mm)
Group 1
mean SD
Inter-canine width 28.3 1.56
Inter-molar width
34.1 2.17
Arch length
28.5 1.56
Group 2
mean SD
28.3 1.95
34.0 2.05
28.4 1.77
Nasal measurements
CONCLUSION.
Combining adenoidectomy with tympanostomy
tube insertion in the treatment of recurrent middle ear infection
does not seem to make any difference in terms of upper dental arch
development or nasal cavity geometry and airway resistance at 5
years compared to tympanostomy tube insertion only.
Mean age 17 m
Group 2
Tympanostomy
+ adenoidectomy
N=74
Min area/right
Min area/left
Total insp.
Group 1
mean SD
0.552 0.489
0.496 0.318
0.344 0.399
Group 2
mean SD
0.384 0.166
0.364 0.138
0.504 1.007