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GEORGE M. MEREDITH, MD
Virginia Beach, Va

Arch Otolaryngol Head Neck Surg. 1990;116(6):741.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—Dr David Austin¹ is to be commended for his courageous second look at adenotonsillectomy visa-vis chronic serous otitis media/recurrent bacterial otitis media. A number of senior otolaryngologists have, for decades, advocated an adenotonsillectomy approach to recurrent bacterial otitis media. Their work was, unfortunately, drowned out by the rush to tympanostomy tube placement. In a way, the tympanostomy tube with its complications of otorrhea, extrusion, cholesterol pearl formation, and persistent perforations represents a double-edged sword. Crying, traumatized, unhappy pediatric otologic patients have "enslaved" two generations of otolaryngologists.

Adenotonsillectomy has proven to be the procedure of choice for the following conditions:

• upper airway compromise^2-4
  
• obstructive sleep apnea^2,5,6
  
• upper airway compromise with secondary cor pulmonale^2,7
  
• aberrant dentofacial development^8-10
  
• recurrent bacterial adenotonsillitis
  
• chronic serous otitis media/bacterial otitis media
  
• some cases of enuresis
  
• excessive daytime sleepiness³
  
• retarded intellectual and physical growth³
  

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