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A group of 67 children were studied (mean age 7 years, 2 months) who underwent adenoidectomy and/or tonsillectomy because of either recurrent otitis media or upper respiratory tract infection. The mean pre-operative intratympanic pressure was –67.3 mmH20 (SD 65.1); three months post-operatively it was –21.9 mmH20 (SD 32.4), a highly significant improvement (p<0.001). The size of the adenoids had a nearly significant effect on the pre-operative intratympanic pressure (p<0.05). In children with large vs small adenoids the difference was highly significant (p<0.001). In a group of five children, tonsillectomy along (adenoidectomy performed earlier) did not have any effect on the intratympanic pressure. No change in intratympanic pressure was seen in children with nasal allergy as compared with non-allergic children after adenoidectomy.