Extending the value of a large research study into glue ear
Research at the University of Cambridge, led by Professor Mark Haggard, is underway to ensure that children receive the most effective treatment for glue ear.
[Project grant, 2006-2008]
At present, there is uncertainty among health professionals about what kind of treatment is best. Some studies have shown that hearing improves in children with glue ear when grommets are fitted and that many children experience further benefit if their adenoids are removed.
This study is helping specialists to decide what treatment is best for each child. The TARGET study (Trial of Alternative Regimens in Glue Ear Treatment) is a multicentre UK randomized controlled trial (RCT) that was carried out in 10 centres in the late 1990’s in collaboration with MRC Multi-Centre Otitis Media Study Group, a large grouping of NHS ENT and audiology departments.
The TARGET study compared bilateral ventilation tubes (or grommets) with and without adjuvant adenoidectomy (the removal of adenoid glands) against non-surgical management in children with bilateral, persistent otitis media with effusion (OME). It is a large and data-rich clinical trial on the physical health and developmental benefits of surgical treatment of uncomplicated but persistent OME (glue ear). This study is extremely important for the benefit of affected children, their families, and for related research training and education in otolaryngology.
TARGET has shown that the average benefits from surgery in glue ear measured on some of the relevant outcomes (beyond just the capacity to hear faint sounds), are substantial in magnitude yet short-lived in duration (ie for ventilation tubes or grommets) or else are extended in duration but only modest in magnitude (ie for adjuvant adenoidectomy). As part of the research, it was shown that children who received grommet insertion and underwent an adenoidectomy were less likely to return for further ENT care. This suggests that a combined approach may be a more effective way of preventing recurrences of glue ear.
Professor Haggard is looking in great detail at the outcome measures and on their difference between the three treatment arms for glue ear: short-stay ventilation tubes (VTs - grommets), VTs plus adenoidectomy, and “watchful waiting” controls. The results are also being combined with data from other European countries.
This study is also generously part-funded by the British Association of Otolaryngologists.
