THE EFFECT OF TONSILLECTOMY ON EUSTACHIAN-TUBE FUNCTION

A two-part study was designed to investigate the effect of tonsillecto my on eustachian tube function and to identify if any change is relate d to postoperative pain. Middle ear pressure was measured by tympanome try and results were classified as type A (+50 daPa to -99 daPa), type B (flat) or type C (-100 daPa to -350 daPa). Thirty-one patients with type A tympanograms, undergoing tonsillectomy enrolled in study A. Pa tients had tympanometry the next day and filled in a questionnaire inc orporating visual analogue pain scores. In study B, 30 patients underw ent a similar protocol and were followed up at 1 week with tympanometr y and a questionnaire. A control group of 26 patients undergoing appen dicectomy was recruited. Follow-up was available on 23 patients from s tudy B. Combining A and B, on the first postoperative day 39% of patie nts developed type C tympanograms. No member of the control group deve loped any change in middle ear pressure. There was no significant rela tionship between pain scores for throat pain or otalgia and the develo pment of negative middle ear pressure. By day 7 all patients had type A tympanograms. Otalgia was a delayed symptom significantly associated with increased throat pain. Transient negative middle ear pressure co mmonly occurs following tonsillectomy.