Sunaina Binth Hamza, Ranjith V. T
BACKGROUND Adenoid hypertrophy (AH) is a common disorder of childhood.1 Adenoid or nasopharyngeal tonsil plays a significant role in the pathogenesis of otitis media with effusion (OME). Enlarged adenoids cause obstruction of eustachian tube (ET) at its pharyngeal opening. It causes reduction in middle ear pressure towards negative side due to absorption of gas leading to OME. There is close relationship between enlarged adenoids and possible middle ear pathology due to alteration of middle ear functions. Otitis media with effusion is the commonest cause of hearing difficulty seen in pre-school and school going children. The aim of this study is to critically appraise the tympanometric findings among children with AH. Tympanometry with an impedance meter has been advocated as a reliable method of detecting OME and is perhaps the most common reference standard diagnostic method because of its availability and semi-objective nature. MATERIALS AND METHODS This observational cross-sectional study was conducted in the Department of Otolaryngology, Government Medical College, Thrissur, for a period of one year from October 2016 to September 2017. Hundred patients were enrolled based on inclusion and exclusion criteria. Detailed history, clinical examination, nasal endoscopy, digital X-ray nasopharynx lateral view and tympanometry were analysed. RESULTS Majority of the children were in the age group 3-5 years and 5-7 years in our study, with male preponderance. Majority of the children presented with the nasal symptoms than aural symptoms. The most common tympanogram found was type B (96 ears, 48%) and the least common was type A (40 ears, 20%). Among the 200 ears tested, 28 cases had unilateral type B, 34 cases had bilateral type B, 36 cases had unilateral type C and 14 cases had bilateral type C tympanograms. CONCLUSION This study has shown that adenoidal hypertrophy is a significant risk factor for OME in children. An Adenoidal-Nasopharyngeal Ratio of 0.72 should be considered as significant pathological enlargement and these children should be routinely sent for tympanometry. This establishes the need for prompt hearing evaluation and management in patients with AH.
