***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A prospect i ve study was performed of children undergoing bilateral ventilation tube insertion . One hundred and twenty-one children aged between 9 months and 10 years 3 months were admitted for surgery for secretory otitis media ( glue ear ) . Each child had a ventilation tube inserted anteriorly in the tympanic membrane of one ear and posteriorly in the tympanic membrane of the other . They underwent regular clinical and audiological assessment until extrusion of the ventilation tubes occurred . Perforations were noted in 2.75 % of tympanic membranes ( 4.6 % of the children ) . The rate with posteriorly placed  ventilation tubes  was higher than with the anteriorly placed ventilation tubes ( 3.7 % compared with 1.8 % ) though this is not statistically significant Fifty-five children with bilateral middle ear effusions were entered into a prospect i ve r and omized double blind trial to determine whether aspiration of middle ear effusions prior to ventilation tube insertion influences ventilation tube extrusion time or the development of tympanosclerosis .  Following myringotomy , aspiration of the left or right ear only was performed r and omly prior to ventilation tube insertion . The tympanic membranes were inspected six-monthly to determine whether ventilation tube extrusion had occurred , and at 24 months after surgery for the presence of tympanosclerosis . Results showed no significant difference in extrusion time between aspirated and non-aspirated ears . Aspiration was found to be a factor in the development of tympanosclerosis . We conclude that routine aspiration of the middle ear effusion prior to ventilation tube insertion is associated with an increased risk of tympanosclerosis One hundred and sixteen children with otitis media with effusion ( OME ) underwent surgery with grommet insertion . A conventional Shah grommet was used in one ear , and a Mini-Shah grommet in the other . Final review of the subjects two years after surgery revealed a significantly lesser degree of tympanosclerosis in the ear into which the Mini-Shah grommet had been inserted . This benefit might have result ed from the lesser mass of the mini-tube or its shorter duration in situ 
    Output:
    
In comparison with watchful waiting or myringotomy ( or both ) , tubes decreased time with OME and improved hearing ; no specific tube type was superior .
Adenoidectomy alone , as an adjunct to myringotomy , or combined with tubes , reduced OME and improved hearing in comparison with either myringotomy or watchful waiting .
Tubes and watchful waiting did not differ in language , cognitive , or academic outcomes .
Otorrhea and tympanosclerosis were more common in ears with tubes .
Adenoidectomy increased the risk of postsurgical hemorrhage .
CONCLUSIONS : Tubes and adenoidectomy reduce time with OME and improve hearing in the short-term .
Both treatments have associated harms .
Large , well-controlled studies could help resolve the risk-benefit ratio by measuring acute otitis media recurrence , functional outcomes , quality of life , and long-term outcomes .