Measuring the correlation between adenoidal-nasopharyngeal ratio (AN ratio) and tympanogram in children Erol Egeli a , Fatih Oghan a, * , Ozcan Ozturk a , Ugur Harputluoglu a , Burhan Yazici b a Department of Otorhinolaryngology and Head and Neck Surgery, Duzce Faculty of Medicine, University of Abant Izzet Baysal, AIBU, Duzce Tıp Fakultesi KBB AD, 81620 Konuralp, Duzce, Turkey b Department of Radiology, Duzce Faculty of Medicine, University of Abant Izzet Baysal, Duzce, Turkey Received 4 March 2004; received in revised form 10 September 2004; accepted 12 September 2004 International Journal of Pediatric Otorhinolaryngology (2005) 69, 229—233 www.elsevier.com/locate/ijporl KEYWORDS Adenoidal- nasopharyngeal ratio; Tympanogram; Adenoid size Summary Objective: To evaluate the correlation between adenoidal-nasopharyngeal ratio (AN ratio) and tympanogram in children. Study design: A prospective clinical study from June 2002 to May 2003. Method: A total of 64 children, aged 6—9 years who presented with nasal obstruction, snoring, mouth breathing, and hyponasal speech were examined and AN ratio was calculated by using the lateral neck radiograms and compared with the tympano- metric values. The relationship between AN ratio and middle-ear pressure was evaluated, regarding the AN ratio of 0.71. The chi-square test was used to analyze the correlation between AN ratio and middle ear pressures and Wilcoxon test was used to compare the changes between the mean AN ratio values, and mean middle ear pressures (including A and C type tympanograms) before and after medical therapy. Results: Middle-ear effusions and C type tympanograms in impedance audiometry were both related to eustachian tube dysfunction resulting from enlargement of the adenoids with AN ratios higher than 0.71. Middle ear pressures were found lower in children with AN ratio greater than 0.71 than in children AN ratio less than 0.71 and the difference was highly significant (p < 0.001). Although medical treatment of large adenoids was rather effective to shrink the adenoid tissue (p < 0.001), it did not cause a statistically significant change in tympanometric values (p > 0.05). Conclusions: Antibiotherapy is effective in reducing adenoid size without signs and symptoms of infection. The reduction of the adenoids in size after 3 weeks of antibiotherapy has an positive effect on recovery of eustachian tube function but is not sufficient in patients with middle ear effusion. Early ventilation tube insertion * Corresponding author. Tel.: +90 380 5414107 2312; fax: +90 380 5414105/5414213. E-mail address: foghan74@hotmail.com (F. Oghan). 0165-5876/$ — see front matter # 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijporl.2004.09.003