Table 3

Key surgical outcomes relevant to the protocol

StudyKey findings
Atef et al30
  • Mean recovery of postoperative area was significantly lower in those exposed to ETS compared with those who were not (p<0.001).

Chen et al29
  • Children resident in households with smokers were at higher risk of cough following previous tonsil/adenoidectomy (p<0.001).

Gov-Ari et al38
  • Smoke exposure was not a significant predictor variable for requiring tonsillectomy after previous adenoidectomy.

Hammarén-Malmi et al28
  • Once confounding factors were controlled for, only maternal smoking increased risk of recurrent acute otitis media (OR 4.15 95% CI 1.45 to 11.9) after tympanostomy tube insertion.

Ilicali et al39
  • No significant difference in early ventilation tube extrusion or persistent otorrhea due to passive smoking demonstrated (maternal smoking OR 0.69 CI 95% 0.29 to 1.67).

Ilicali et al32
  • No significant difference in postoperative complication rates due to ETS exposure.

Kim et al40
  • Indirect smoking not significantly associated with being in poor outcome group.

  • Multivariate model showed indirect smoking as marginally significant factor (OR 3.377 CI 95% 1.032 to 11.053).

Maw and Bawden31
  • Hazard rate for resolution in ears exposed to parental smoke, 0.61 (CI 95% 0.47 to 0.79). Parental smoking detrimental to clearance of fluid in Cox regression analysis.

Praveen and Terry35
  • Lower median survival of grommet if both parents smoke (59.9 weeks CI 95% 53.9 to 65.9) vs neither parent smokes (86.0 weeks CI 95% 78.7 to 93.3).

  • Increased infection rate for passive smoke exposure (p <0.001).

  • Increased myringosclerosis for passive smoke exposure (64% vs 20%, p<0.001).

  • Rate of second look abnormal findings in no steroid group, 100% in ETS exposed vs 65% in non-ETS exposed; and 43% in ETS exposed vs 25% in non-ETS exposed for steroid-treated group. No statistics calculated.

  • Univariate analysis showed no significant difference in success rate due to smoke exposure. Multivariate analysis reported cigarette smoke exposure as predictor of success (no statistics presented).

Ramadan and Hinerman36
  • Endoscopic sinus surgery less successful in ETS exposed (70% vs 90%, p=0.007).

  • Multivariate analysis showed smoke exposure a significant factor (OR 3.7 95% CI 1.2 to 11.3).

  • ETS, environmental tobacco smoke.