Glue ear: don't operate

Recurrent acute otitis media is a painful and nasty disease of the middle ear, and can be especially distressing if it affects the very young.

In similar vein to the previous story, the doctor may feel he has to do something, and that something is often an adenoidectomy, or removal of the adenoids. The adenoids play a vital role in helping a child develop immunity, and they can swell when they become infected. When they become infected they swell, so blocking the eustachion tube, which, in turn, can cause otitis media, or glue ear.

The removal of the adenoids is a relatively simple procedure, provided the surgeon has ensured that all bleeding has been stopped - except that it doesn't work.

Researchers in Finland tested the effectiveness of an adenoidectomy against a placebo on a group of 180 children aged between 10 months and 2 years who suffered recurrent otitis media.

But there was no difference between the two groups afterwards. They suffered similar numbers of subsequent attacks, visits to the doctor and antibiotic prescriptions, except that one group no longer had their adenoids and might suffer other problems because of an inadequate immune system.

(Source: British Medical Journal, 2004; 328: 487-90).