Adenoidectomy is a common procedure undertaken for obstructive sleep apnoea and nasal obstruction. Curettage is the most common technique but is associated with complications (mucosal trauma, bleeding) that may cause eustachian tube dysfunction (ETD). This study analysed changes in middle ear pressure in 64 children divided into two groups (group A <6 years old, group B >6 years old). These patients underwent adenoidectomy for adenoidal hypertrophy without otitis media with effusion. All adenoidectomies were done in the same centre using a standardised technique. Mean age was 91 months and all patients had Jerger type A tympanometry preoperatively. In the first 24 hours following adenoidectomy, decreases in middle ear pressures were seen in both ears. Three days after surgery, middle ear pressure started to increase in both ears. Middle ear pressures returned to preoperative values by the seventh postoperative day for both ears except in two patients. There were no statistically significant differences between right and left middle ear pressure preoperatively and on the first, third and seventh postoperative day. When groups A and B were evaluated separately, there were no statistically significant differences between right and left middle ear pressure preoperatively and on the first, third and seventh postoperative day in both groups. This study highlights that parents should be warned about the risk of ETD as a result of adenoidectomy, though this should be a temporary problem in most. Techniques that minimise local trauma or bleeding, such as microdebrider or endoscopically assisted laser adenoidectomy, may reduce the risk of ETD. Further comparative studies are advocated by the authors.
Curettage adenoidectomy impairs eustachian tube function
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