Adenoidectomy and Chronic Otitis Media

To the Editor: Dr. Gates and his colleagues have contributed valuable data in support of the limited effectiveness of adenoidectomy and of tympanostomy-tube placement in certain children with persistent middle-ear effusion.¹ The findings bear directly on two common clinical decisions: which operation to choose if surgery of some sort is deemed advisable for middle-ear effusion, and what circumstances justify surgical intervention of any sort. The authors' discussion of these issues prompts our comments. The authors believe that adenoidectomy is justified “as part of the primary surgical therapy” in children such as those they studied, because the outcomes were generally better.