Introduction: Enlarged adenoids may cause obstruction of the nasopharynx and blockage of the Eustachian tube and thereby preventing ventilation of the middle ear – mastoid system. It can also act as a reservoir for bacteria causing frequent middle ear infections. This study was done to assess the middle ear pressure (MEP) and hearing threshold before and after adenoidectomy or adenotonsillectomy. Materials and Methods: Fifty-four children aged between 4 and 12 years undergoing adenoidectomy or adenotonsillectomy were included in the study. Pure tone audiometry (PTA) and impedance audiometry were done preoperatively and postoperatively twice, on the 2nd day and at 6th week to assess the changes in hearing threshold and MEP. Statistical analysis was done using paired t-test and Chi-square test to determine the changes in hearing threshold and MEP. P < 0.05 was found to be statistically significant. Results: Of the 54 patients (108 ears) studied, 26 ears (24%) showed air–fluid level and 19 ears (17.6%) had dull-retracted tympanic membrane. The mean preoperative PTA value was 15.95 ± 8.19 dB. The mean preoperative MEP value was −63.69 ± 88.9 mm H2O. Postoperatively on 2nd postday, both the values were higher and at 6th week, there was an improvement as compared to preoperative and immediate postoperative values. At 6th week postoperatively, it was also observed that 52 children had tympanogram as type A, confirming the improvement in MEP. All these changes were statistically significant (P < 0.005). Conclusion: Adenoidectomy or adenotonsillectomy alone does improve the Eustachian tube function, especially in otitis media with effusion. Myringotomy with grommet insertion may not be necessary in all the cases.

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