title: Measuring the correlation between adenoidal-nasopharyngeal ratio (AN ratio) and tympanogram in children.
abstract: OBJECTIVE
  To evaluate the correlation between adenoidal-nasopharyngeal ratio (AN ratio) and tympanogram in children.
  
  
  METHODS
  A prospective clinical study from June 2002 to May 2003.
  
  
  METHODS
  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 tympanometric 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 may be an alternative therapy for the middle ear effusions not improving by 3 weeks medical therapy.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Duzce Faculty of Medicine, University of Abant Izzet Baysal, AIBU, Duzce Tip Fakultesi KBB AD, 81620 Konuralp, Duzce, Turkey.
authors.forename: Erol
authors.initials: E
authors.lastname: Egeli
authors.forename: Fatih
authors.initials: F
authors.lastname: Oghan
authors.forename: Ozcan
authors.initials: O
authors.lastname: Ozturk
authors.forename: Ugur
authors.initials: U
authors.lastname: Harputluoglu
authors.forename: Burhan
authors.initials: B
authors.lastname: Yazici
mesh_terms: D000158:Acoustic Impedance Tests; D000234:Adenoids / Q000000981:diagnostic imaging / Q000473:pathology*; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D004432:Ear, Middle / Q000503:physiopathology; D005064:Eustachian Tube / Q000503:physiopathology; D005260:Female; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D006965:Hyperplasia / Q000150:complications / Q000188:drug therapy; D008297:Male; D009058:Mouth Breathing / Q000209:etiology; D015508:Nasal Obstruction / Q000209:etiology; D009305:Nasopharynx / Q000000981:diagnostic imaging / Q000473:pathology*; D011312:Pressure; D011446:Prospective Studies; D011859:Radiography; D012913:Snoring / Q000209:etiology; D013064:Speech Disorders / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin