Middle ear pressure changes pre and post adenoidectomy and/or tonsillectomy

ABSTRACT

Middle ear diseases secondary to upper respiratory tract infection or obstruction is a common pathological condition. Eustachian tube dysfunction is widely accepted as an important contributory cause of diseases of the middle ear. Some investigators support the opinion that mechanical obstruction of the Eustachian tube could occur due to the bulk of big adenoids. Others consider the effect of inflammatory oedema, due to secondary salpingitis from infected adenoids on tubal patency. Adenoidectomy and/or tonsillectomy are controversial operations as regard their effect on the middle ear areation and pressure. They are frequently undertaken to improve the Eustachian tube function in children and less frequently in adults. Seventy children aged between 4-10 years of both sexes were chosen from the E.N.T. outpatient clinic of El-Minia University Hospital and all had the criteria favoring adenoidectomy and/or tonsillectomy. They were divided into three groups [A] 30 Children were subjected to tonsillectomy alone, [B] 30 children were subjected to adenotonsillectomy, [C] 10 children were subjected to adenoidectomy alone. It can be concluded that hypertrophied adenoids cause. Eustachian malfunction resulting in increased negative middle ear pressure. Also, adenoidectomy especially if big or moderate sized, had a favorable effect in improving the middle ear pressure and the Eustachian tube function. So, early adenoidectomy may impede the onset of secretory otitis media and thus eliminating the need for ventilation tube