(1061) Technique Choice Has Significant Effect on Eustachian Tube Function Postadenoidectomy: A Systematic Review and Meta-analysis

Introduction: The purpose of this study was to determine if adenoidectomy technique influences eustachian tube function (ETF) outcomes postoperatively.

Methods: A literature search was performed on Pubmed in January 2024. Inclusion criteria included 1) reported pre and postoperative tympanometry results, 2) reported technique utilized for adenoidectomy, 3) pediatric patient population, 4) no concurrent otologic procedures, 5) follow up data at least one month post procedure to document sustained change in ETF, and 6) sufficient granularity of data for analysis. Extracted data included adenoidectomy technique, pre- and post-operative tympanogram results, and pre and post-operative middle ear pressures. Primary outcome was improvement in ETF, defined as progression to a Type A tympanogram.

Results: 720 abstracts were screened, 20 underwent full-text review, and four studies ultimately met inclusion criteria for our study. Two adenoidectomy techniques were compared in each study: conventional curettage, and endoscopic microdebrider. Of 257 reported ears, 84.43% improved after adenoidectomy with endoscopic microdebrider. Of 244 reported ears, 72.95% improved after conventional adenoidectomy with curettage. On meta-analysis, the endoscopic microdebrider technique had superior odds of achieving a sustained postoperative type A tympanogram.

Conclusions: Significant ETF improvement is noted following both procedures, with improved odds with the endoscopic microdebrider technique, possibly due to improved visualization. Further studies considering other common techniques (suction cautery, coblation) are needed.