Analysis of influencing factors for tympanic dysfunction associated with adenoid hypertrophy in children and outcomes after adenoidectomy

OBJECTIVE: To investigate the risk factors for tympanic dysfunction in children with adenoid hypertrophy (AH) and to analyze the outcomes following adenoidectomy. METHODS: A retrospective analysis was conducted on 210 children who underwent adenoid ablation surgery. Patients were divided into a tympanic dysfunction group (TAG, n = 62) and a normal tympanic function group (TNG, n = 148) based on preoperative tympanometry (Type B/C vs. Type A). Univariate and multivariate logistic regression analyses were employed to identify independent risk factors. Postoperative tympanometry was followed up in a subset of patients to assess efficacy. RESULTS: The prevalence of tympanic dysfunction among AH children was 29.5% (62/210), with 13 Type B (21.0%) and 49 Type C (79.0%). Univariate analysis identified age, adenoid grade, degree of nasal congestion, presence of sinusitis, excessive phlegm/post-nasal drip, and gastroesophageal reflux symptoms as significant factors (P < 0.05). Multivariate analysis confirmed that higher adenoid grade (Grade 4 vs. Grade 3: OR = 3.00, 95% CI: 1.39-6.50, P = 0.005) and more severe nasal congestion (OR = 1.349, 95%CI: 1.024-1.776, P = 0.033) were independent risk factors. Postoperative follow-up of 24 TAG patients showed significant improvement (McNemar test, P < 0.001), with 91.7% achieved normal tympanic function at 6 weeks. Recovery rates did not differ between Type B and C patients (2 weeks: 62.5% vs. 68.8%, P = 1.000; 6 weeks: 100% vs. 87.5%, P = 0.493). CONCLUSION: Adenoid grade and the severity of nasal congestion are independent risk factors for tympanic dysfunction in children with AH. Adenoidectomy is highly effective in restoring middle ear function in most patients. Early identification of these risk factors and timely surgical intervention are crucial for improving outcomes.