Niemi P 1 , Numminen J 2 , Rautiainen M 2 , Helminen M 3 , Peltomäki T 4

1. THE EFFECT OF EARLY ADENOIDECTOMY ON NASAL CAVITY VOLUME AND UPPER DENTAL ARCH DIMENSIONS IN CHILDREN WITH RECURRENT MIDDLE EAR INFECTION 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. Niemi P1, Numminen J2, Rautiainen M2, Helminen M3, Peltomäki T4 ¹Department of Maxillofacial Surgery and Oral Diseases, Satakunta Central Hospital, 2Department of Otorhinolaryngology, Tampere University Hospital, 3 Science center, Pirkanmaa Hospital District and School of Health Sciences, University of Tampere and ⁴Oral and Maxillofacial Unit, Tampere University Hospital, Finland HYPOTHESIS. It is hypothesized that children with tympanostomy tube insertion with adenoidectomy have more optimal occlusal development than children with tympanostomy tube insertion alone. • Eligiblepatients (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 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. Randomization Group 2 Tympanostomy + adenoidectomy N=74 Group 1 Tympanostomy n=63 Mean age 17 m Orthodontic and ENT examination n=41 14♀, 27 ♂ Orthodontic and ENT examination n=59 17♀, 42 ♂ Mean age 5.2 yrs Dental arch measurements (mm) Group 1 Group 2 mean SD mean SD Inter-canine width 28.3 1.56 28.3 1.95 Inter-molar width 34.1 2.17 34.0 2.05 Arch length 28.5 1.56 28.4 1.77 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. Nasal measurements Group 1 Group 2 mean SD mean SD Min area/right 0.552 0.489 0.384 0.166 Min area/left 0.496 0.318 0.364 0.138 Total insp. 0.344 0.399 0.504 1.007 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.