The Influence of Adenoids on Middle Ear Disease. A Literature Review.

The significance of adenoids in the pathogenesis of otitis media was investigated by reviewing recent literature. Adenoids are not likely to cause otitis media by compressing the eustachian tube, but are important as a reservoir of chronic infection supplying bacteria to the middle ear. Chronic infection of the adenoids by Haemophilus influenzae (particularly the non-typable strain) or Branhamella catarrharis may result in alterations of colonization by normal flora and impairment of the local immunological defense system in the adenoids; these in turn, may cause recurrent otitis media. Although the short-term effect of adenoidectomy on otitis media has been confirmed in several randomized clinical trials, its long-term effects, particularly on intractable otitis media, are questionable. Indications for adenoidectomy should, therefore, be evaluated on an individual basis, and include consideration of patient age, the presence or absence of a history of recurrent otitis media, chronic rhinosinusitis, and the results of bacteriological examination in the nasopharynx.