Our Summary

This research paper is an update of the 2015 guidelines set forth by the Japanese Otological Society and Oto-Rhino-Laryngeal Society of Japan. It focuses on a condition called otitis media with effusion (OME), which is an ear disease, usually seen in children younger than 12 years. The paper goes over the rate of the disease, how to diagnose it, and how to examine it.

The researchers updated the recommended treatments based on current procedures used in Japan and the latest scientific evidence available. They did this by developing clinical questions (CQs) and researching documents related to the disease’s definition, condition, diagnosis method, and medical treatment.

OME in children was divided into two groups. One group has no risk of developing a chronic or stubborn disease, while the other has a higher risk. This group includes children with Down syndrome or a cleft palate. The paper provides advice for managing the disease, including how to follow up with patients, and gives special attention to children with one-sided OME and stubborn cases complicated by sticky otitis media.

The conclusion is that the Japanese Clinical Practice Guidelines recommend treating not only complications of OME itself, like fluid in the middle ear and changes in the eardrum, but also changes in surrounding organs related to infectious or inflammatory diseases.

FAQs

  1. What is the main focus of this updated research paper by the Japanese Otological Society and Oto-Rhino-Laryngeal Society of Japan?
  2. How did the researchers update the recommended treatments for otitis media with effusion (OME)?
  3. How does the paper recommend managing children with one-sided OME and stubborn cases complicated by sticky otitis media?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adenoidectomy is to follow post-operative care instructions closely to ensure a smooth recovery. This may include avoiding strenuous activities, getting plenty of rest, staying hydrated, and taking any prescribed medications as directed. It is also important to attend follow-up appointments with your doctor to monitor healing progress and address any concerns.

Suitable For

Adenoidectomy is typically recommended for patients with OME who have persistent symptoms despite medical treatment, such as hearing loss, recurrent acute otitis media, speech delay, or developmental delay. It is also recommended for patients with complications of OME, such as adhesive otitis media or cholesteatoma. Additionally, adenoidectomy may be considered for patients with recurrent upper respiratory infections or sleep-disordered breathing associated with OME. Overall, adenoidectomy is recommended for patients with OME who have failed medical management and are at risk for developing chronic or stubborn disease.

Timeline

Before an adenoidectomy, a patient may experience symptoms such as frequent ear infections, difficulty breathing through the nose, snoring, sleep apnea, and chronic sinus infections. They may undergo a series of medical evaluations, including a physical examination, imaging tests, and possibly a sleep study. Once a decision is made to proceed with adenoidectomy, the patient will undergo preoperative testing and preparation.

After the adenoidectomy procedure, the patient may experience some discomfort, swelling, and mild pain in the throat and ears. They may also experience some nasal congestion and a mild sore throat. Pain medication and antibiotics may be prescribed to help with these symptoms. The patient will be advised to avoid strenuous activities, follow a soft diet, and stay hydrated. Follow-up appointments will be scheduled to monitor the healing process and ensure there are no complications. Over time, the patient should experience relief from their symptoms and improved breathing and overall health.

What to Ask Your Doctor

Some questions a patient may consider asking their doctor about adenoidectomy include:

  1. What is an adenoidectomy and why is it recommended for my condition?
  2. What are the risks and potential complications associated with adenoidectomy?
  3. How will adenoidectomy improve my symptoms or condition?
  4. What is the recovery process like after adenoidectomy?
  5. Are there any alternative treatments or options available besides adenoidectomy?
  6. How long will it take for me to see improvements in my symptoms after the procedure?
  7. Are there any long-term effects or considerations I should be aware of after undergoing adenoidectomy?
  8. How frequently will I need follow-up appointments after the procedure?
  9. Are there any specific instructions or precautions I should follow before and after the surgery?
  10. What is the success rate of adenoidectomy for patients with my particular condition?

Reference

Authors: Hidaka H, Ito M, Ikeda R, Kamide Y, Kuroki H, Nakano A, Yoshida H, Takahashi H, Iino Y, Harabuchi Y, Kobayashi H. Journal: Auris Nasus Larynx. 2023 Oct;50(5):655-699. doi: 10.1016/j.anl.2022.12.004. Epub 2022 Dec 27. PMID: 36577619