Background: There is a lot of controversy about the role of adenoidectomy and myringotomy with ventilation tubes insertion (MVT) in management of otitis media with effusion (OME). In a previous study we found that endoscopic-assisted peritubal adenoidectomy (EPA) resulted in cure of most patients without the need of MVT. We adopted this technique and modified it in the last 20 years.
Aim: To describe and evaluate the results of EPA in management of OME in both new and recurrent cases after previous surgery, and whether we can avoid MVT or not.
Patients and Methods: Our techniques for EPA and MVT were described. Three studies were performed, including 282 patients. Study 1: randomized (prospective) study included 110 new non-operated cases. Study 2: Retrospective study, included 120 new non-operated patients with selected criteria. Study 3: Recurrent cases: It included 52 patients after previous surgery. Each study included 2 subgroups: a- EPA. b- EPA+MVT for comparison.
Results: There were no statistically significant differences between the 2 subgroups in the three studies. EPA had the same success rate as compared with EPA+MVT. Complications were recorded and discussed.
Conclusion: Endoscopic examination and removal of peritubal adenoid remnants were major cornerstone step in management of OME. We can avoid MVT by this technique, without complications in most cases.