Ear-infection surgery has limited gain.

Removing a child's adenoids as a remedy for repeated ear infections is recommended for certain patients. A new study, however, suggests this drastic measure doesn't provide much more help in the long term than standard antibiotic treatment.

Scientists determined subsequent infection rates in 280 children who received medication and underwent surgery for recurrent ear infections. These rates were compared with those of 181 others who had received medication only. Some of the 280 children also had their tonsils removed. The researchers found that in the first year, those whose adenoids and tonsils were removed had about two-thirds as many ear infections as those getting medication alone, but this advantage disappeared in the second and third years after surgery.

The long-term leveling of the therapies' effects might simply reflect the fact that most children grow out of ear infections, says study coauthor Jack L. Paradise, a pediatrician at the Children's Hospital of Pittsburgh and the University of Pittsburgh.

Surgery to remove adenoids alone provided even less protection than the combined surgery, Paradise and his colleagues report in the Sept. 8 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

Meanwhile, nearly 15 percent of surgical patients suffered from complications such as pneumonia or hemorrhage. Children in all groups received 10 days to 6 weeks of antibiotics.

Children with recurrent ear infections that antibiotics don't allay might benefit more from minor surgery to implant tubes that ventilate the middle ear, Paradise suggests, than from the major surgery of tonsillectomy or adenoidectomy. In severe cases where tubes fail to keep the middle ear healthy, however, Paradise says, surgery is the best option.