ConclusionS -carboxymethylcysteine is effective in the treatment of children with glue ear .
Objective To establish the clinical relevance of S-carboxymethylcysteine in the treatment of glue ear in children using measures approximating those saving a child from operation for grommet insertion .
Surgery of the tonsils and adenoids in relation to secretory otitis media in children.
One hundred and fifty children aged between 2 and 9 years with bilateral SOM were allocated at r and om to three groups : Adeno-tonsillectomy ( 47 cases ) , adenoidectomy ( 47 cases ) and neither procedure ( 53 cases ) . A further 42 children were allocated to either adenoidectomy or no surgery . In all only one ear was treated at r and om by myringotomy and insertion of a ventilation tube . The unoperated ear was examined six weeks , six months , nine months , one , two and three years post-operatively for otoscopic clearance of the effusion , impedance change and improvement in mean hearing threshold . Thus the effects on middle ear status of adenoidectomy alone and in combination with tonsillectomy were assessed . There was a significant clearance of middle ear fluid , change from no peak to peak impedance measurement and hearing gain as a result of both procedures with a late trend favouring the combined operation . Neither pre-operative tonsils size nor the number of attacks of tonsillitis affect outcome . However there is a relationship between age and radiographic post-nasal space airway size with clearance of the effusion one year after surgery . These findings permit recommendation for adenoidectomy with improved expectation for resolution of SOM if cases are selected with reference to these two variables . They also suggest in which cases the operation should not be recommended . Despite the trends in outcome favouring combined operations , the extra morbidity associated with the addition of tonsillectomy does not at present justify recommendation for removal of the tonsils in addition to adenoidectomy for cases with SOM . Tonsillectomy in these children should be assessed on grounds of tonsillar pathology per se and not on the status of the middle ear
ConclusionS -carboxymethylcysteine is effective in the treatment of children with glue ear .
Objective To establish the clinical relevance of S-carboxymethylcysteine in the treatment of glue ear in children using measures approximating those saving a child from operation for grommet insertion .