Improvement in Eustachian Tube Function after Endoscopic Sinus Surgery for Polypoid Chronic Rhinosinusitis

Background: Patients with chronic rhinosinusitis (CRS) often have Eustachian tube dysfunction (ETD) symptoms. This study aimed to prospectively investigate the effect of endoscopic sinus surgery (ESS) on improvement of Eustachian tube function in CRS patients with ETD from a Chinese population and determine factors associated with improvement. Methods: A prospective study was performed in CRS patients with ETD who underwent ESS from 3 tertiary medical centers in south China. The Eustachian tube Dysfunction Questionnaire 7 (ETDQ-7), Sinonasal Outcome Test 22 (SNOT-22), tympanograms, endoscopic findings and Valsalva maneuver were recorded and analyzed preoperatively and postoperatively at 8-12 weeks. Results: A total of 70 CRS patients with ETD were included in this study. The ETDQ-7 score and the ability of positive Valsalva maneuver in CRS patients were significantly improved postoperatively at 8-12 weeks. The number of patients with type A tympanogram was increased postoperatively. Reduced Eustachian tube mucosal inflammation was also observed postoperatively. In addition, ESS appeared to reverse slight tympanic membrane atelectasis after 8-12 weeks. Moreover, improvement in tympanogram was presented in more than half of CRS patients with concomitant otitis media with effusion postoperatively at 8-12 weeks. Univariate and multivariate analysis revealed failure of normalization of ETDQ-7 postoperatively was associated with concomitant allergic rhinitis and higher preoperative SNOT-22 score. Conclusions: This study confirms Eustachian tube function is often improved after ESS in CRS patients with ETD. Concomitant allergic rhinitis and higher preoperative SNOT-22 score are associated with failure of normalization of ETD symptoms.

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Eustachian tube symptoms are frequent in chronic rhinosinusitis and respond well to endoscopic sinus surgery

Rhinology Journal ◽

10.4193/rhin17.165 ◽

2018 ◽

Vol 56 (2) ◽

pp. 118-121 ◽

Cited By ~ 4

Author(s):

A. Maniakas ◽

M. Desrosiers ◽

M.H. Asmar ◽

M. Al Falasi ◽

L.M. Endam ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Eustachian Tube ◽

Endoscopic Sinus Surgery ◽

Sinus Surgery

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Eustachian Tube dysfunction in chronic rhinosinusitis: pre and post-operative results following endoscopic sinus surgery, a prospective study

Rhinology Journal ◽

10.4193/rhin18.208 ◽

2018 ◽

Author(s):

Philippe F.D. Bowles ◽

Satish Agrawal ◽

Mahmoud A. Salam

Keyword(s):

Prospective Study ◽

Chronic Rhinosinusitis ◽

Eustachian Tube ◽

Endoscopic Sinus Surgery ◽

Eustachian Tube Dysfunction ◽

Sinus Surgery ◽

Operative Results ◽

Tube Dysfunction ◽

A Prospective Study

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The Effect of Endoscopic Sinus Surgery on Symptoms of Eustachian Tube Dysfunction

American Journal of Rhinology ◽

10.1177/194589240501900214 ◽

2005 ◽

Vol 19 (2) ◽

pp. 199-202 ◽

Cited By ~ 18

Author(s):

Nathaniel F.N. Stoikes ◽

Jay M. Dutton

Keyword(s):

Chronic Rhinosinusitis ◽

Eustachian Tube ◽

Endoscopic Sinus Surgery ◽

Eustachian Tube Dysfunction ◽

Sinus Surgery ◽

Significant Treatment ◽

Tube Dysfunction ◽

Minor Symptom ◽

A Minor ◽

Tubal Dysfunction

Background The symptom of eustachian tube dysfunction has been categorized as a “minor” symptom in chronic rhinosinusitis. The aim of this pilot study was to determine the frequency of otologic symptoms in patients with confirmed rhinosinusitis and the likelihood of its resolution in those patients undergoing endoscopic sinus surgery (ESS). Methods Questionnaires were obtained from 168 patients who had undergone prior ESS over a 5-year period. Patients were asked to evaluate if they suffered from several different potential symptoms of eustachian tube dysfunction before ESS and whether that symptom changed postoperatively. Results Using the binomial test, 95% confidence intervals were determined for the following otologic symptoms of tubal dysfunction: “ear fullness and congestion,” “ear cracking and popping,” “dizziness,” and “ear pain.” ESS was found to have a significant treatment effect for the indicated otologic symptoms of tubal dysfunction. Conclusion Tubal dysfunction, as manifested by otologic symptoms, is common in patients with chronic rhinosinusitis undergoing ESS. The classification of this as a “minor” symptom of rhinosinusitis needs to be reevaluated. These symptoms improve or resolve in the majority of patients undergoing ESS.

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Sinonasal Polyposis and Its Effect on Eustachian Tube Function

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1273 ◽

2016 ◽

Vol 9 (2) ◽

pp. 77-80

Author(s):

Santosh B Mane ◽

Kalpana S Dasgupta

Keyword(s):

Eustachian Tube ◽

Nasal Polyposis ◽

Otitis Media With Effusion ◽

Sinus Surgery ◽

Eustachian Tube Function ◽

Sinus Disease ◽

Tube Dysfunction ◽

Tube Function ◽

Paranasal Sinus Disease ◽

Sinonasal Polyposis

ABSTRACT Objective/hypothesis Nasal and paranasal sinus disease can cause Eustachian tube (ET) dysfunction leading to middle ear (ME) hypoventilation. Persistent ME hypoventilation can result in ME conditions like retraction of tympanic membrane, otitis media with effusion, and chronic ME disease. Aim Aim of this study was to evaluate the ET function in cases of sinonasal polyposis. Evaluation was done by doing tympanometry. Materials and methods This was a hospital-based prospective study consisting of 42 patients (84 ears) of nasal polyposis, of which 27 patients had antrochoanal (AC) polyp and 15 patients had ethmoidal polypi. After thorough history and detail clinical examination, tympanometry was done in all patients 1 day prior to surgery and 4 to 6 weeks after surgery. Results Preoperatively in 30 ears (15 patients) of ethmoidal polypi had normal tympanogram (A type) in 40% ears and abnormal tympanogram (B and C) in 60% ears. Postoperatively 80% had A tympanograms and 20% had abnormal tympanogram. There was significant improvement on removal of polypi (p = 0.004). Preoperatively 54 ears (27 patients) of AC polyp had normal tympanogram (type A) in 55.56% ears and abnormal tympanogram (B and C) in 44.44% ears. Postoperatively normal tympanogram was seen in 81.48% and abnormal tympanogram in 18.52% ears, so there was significant improvement after functional endoscopic sinus surgery (p = 0.007). Conclusion Eustachian tube dysfunction was present preoperatively in 60 and 44.44% in ethmoidal and AC polypi respectively, while in postoperative period dysfunction was 20 and 18.52%. So function improves on removal of polyp. How to cite this article Mane SB, Dasgupta KS. Sinonasal Polyposis and Its Effect on Eustachian Tube Function. Clin Rhinol An Int J 2016;9(2):77-80.

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Effect of Endoscopic Sinus Surgery on Eustachian Tube Function in Adult Sinusitis Patients: A Prospective Case-Control Study

Journal of Clinical Medicine ◽

10.3390/jcm10204689 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4689

Author(s):

Kyu Young Choi ◽

Sookyung Jang ◽

Ganghyeon Seo ◽

Su-Kyoung Park

Keyword(s):

Multivariate Analysis ◽

Eustachian Tube ◽

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Binary Logistic Regression ◽

Sinus Surgery ◽

Binary Logistic Regression Analysis ◽

Tube Function ◽

The Right ◽

Valsalva Test

The eustachian tube (E-tube) function is known to be related with sinusitis; however, the effect of endoscopic sinus surgery (ESS) on E-tube function is not clearly documented. This study aimed to prospectively evaluate the function of the E-tube by using both subjective and objective tests in adult chronic sinusitis patients undergoing ESS, and to compare with those of the patients without sinusitis. Thirty adult patients who underwent ESS for treatment of chronic sinusitis and another thirty patients without sinusitis who underwent other nasal surgeries (septoplasty, rhinoplasty, or closed reduction) were evaluated and compared for E-tube function before and after three months of their surgeries. The E-tube function tests included the seven-item eustachian tube dysfunction questionnaire (ETDQ-7), Valsalva test, and inflation-deflation test that were compared preoperatively and postoperatively in both groups. Compared with the group without sinusitis, the ESS group showed significant improvement of E-tube function after surgery in the ETDQ-7 (p = 0.002), right Valsalva test (p = 0.015), right deflation test (p = 0.005), and left deflation test (p = 0.006). A binary logistic regression analysis revealed that ESS significantly improved E-tube function in the right Valsalva test in a univariate (p = 0.021) and multivariate analysis (p = 0.008), and E-tube function in the left deflation test in a univariate (p = 0.021) and multivariate analysis (p = 0.039). These findings indicate that E-tube function is significantly improved after ESS in adult sinusitis patients, and that the presence of sinusitis and implementation of ESS should be considered (if sinusitis is present) in managing patients with ear diseases that are affected by E-tube function.

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