The effect of tonsillectomy and adenoidectomy on the intra-tympanic pressure

Abstract

A group of 67 children were studied (mean age 7 years, 2 months) who underwent adenoidectomy and/or tonsillectomy because of either recurrent otitis media or upper respiratory tract infection. The mean pre-operative intratympanic pressure was –67.3 mmH20 (SD 65.1); three months post-operatively it was –21.9 mmH20 (SD 32.4), a highly significant improvement (p<0.001). The size of the adenoids had a nearly significant effect on the pre-operative intratympanic pressure (p<0.05). In children with large vs small adenoids the difference was highly significant (p<0.001). In a group of five children, tonsillectomy along (adenoidectomy performed earlier) did not have any effect on the intratympanic pressure. No change in intratympanic pressure was seen in children with nasal allergy as compared with non-allergic children after adenoidectomy.

Measuring the correlation between adenoidal-nasopharyngeal ratio (AN ratio) and tympanogram in children

“…In this study we showed the effect of the adenoid vegetation on the eustachian tube without infectious diseases such as acute and chronic adenoiditis and we found that the number of B and C type tympanograms was significantly greater in the children with AN ratios higher than 0.71 as compared to the ones with the ratio of lower than 0.71 and there was a statistical significance in respect of types of tympanograms between the groups. Tuohimaa et al [13] had similar results with us and also examined 67 children with healthy tympanic membranes, by means of impedance audiometry, before and 3 months after adenoidectomy and/or tonsillectomy. The difference between the groups with small adenoids and large adenoids was highly significant.…”

“…Alhady et al [12] found that the mean values of middle-ear pressure were very highly significant in patients with adenoid hyperplasia. Tuohimaa et al [13] examined 67 children with intact tympanic membranes, by means of impedance audiometry and found difference between the groups with small adenoids and large adenoids was highly significant.…”

The effect of adenoid hypertrophy on tympanometric findings in children without hearing loss

“…[7] Current studies showed the mean values of middle-ear pressure were significantly higher in patients with adenoid hypertrophy. [8][9][10] The airflow passing through the relatively narrower lumen will cause a negative pressure which will induce tubal dysfunction in the most severe cases. [5] Alhady and Sharnoubi [8] reported that eustachian tube dysfunction is maximum in patients with obstructing adenoids, less in chronic sinusitis and least in chronic tonsillitis.…”

Microbiology of Healthy and Diseased Adenoids

“…The adenoids are believed to play a role in several infectious and noninfectious upper airway illnesses. They may be implicated in the etiology of otitis media, 1–6 rhinosinusitis, 1,4,7,8 adenotonsillitis, 9 and chronic nasal obstruction, because of their hypertrophy. 10,11 …”

“…The adenoids are believed to play a role in several infectious and noninfectious upper airway illnesses. They may be implicated in the etiology of otitis media, 1-6 rhinosinusitis, 1,4,7,8 adenotonsillitis, 9 and chronic nasal obstruction, because of their hypertrophy. 10,11 Establishing the unique microbiology of the adenoids in patients with a variety of pathological conditions is important, as it can assist in their management.…”