The Effect of Endoscopic Sinus Surgery on Eustachian Tube Dysfunction Symptoms

2020 ◽  
Vol 163 (3) ◽  
pp. 603-610
Author(s):  
Michael T. Chang ◽  
Davood K. Hosseini ◽  
Sun Hee Song ◽  
Jayakar V. Nayak ◽  
Zara M. Patel ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Endoscopic Sinus Surgery ◽  
Retrospective Chart Review ◽  
Eustachian Tube Dysfunction ◽  
Sinus Surgery ◽  
Level Of Evidence ◽  
Factors Associated ◽  
Academic Center ◽  
Tube Dysfunction ◽  
Snot 22

Objective We assessed how eustachian tube dysfunction (ETD) changed with endoscopic sinus surgery (ESS) and identified factors associated with improvement. Study Design Retrospective chart review. Setting Academic center. Subjects and Methods Patients undergoing ESS for chronic rhinosinusitis with and without nasal polyposis (CRSwNP, CRSsNP) or recurrent acute rhinosinusitis (RARS) completed the Eustachian Tube Dysfunction Questionnaire 7 (ETDQ-7) preoperatively and postoperatively at 2 weeks, 6 weeks, 3 months, and 6 months. Included in analyses were demographics, comorbidities, Sinonasal Outcome Test 22 (SNOT-22), radiographic score, endoscopy score, procedure, and medication use. Regression analysis identified factors associated with improvement, defined as ΔETDQ-7 >3.5. Results In total, 302 patients were studied. ETD prevalence was 68% in CRSsNP, 48% in CRSwNP, and 88% in RARS. Patients with ETD had a mean baseline ETDQ-7 of 25.8 ± 8.0 and improved postoperatively at 2 weeks (19.9 ± 8.1, P < .001), 6 weeks (17.8 ± 9.3, P < .001), 3 months (16.8 ± 8.5, P < .001), and 6 months (16.4 ± 7.9, P < .001). At 6 months, ETD improved in 89% of patients with CRSsNP, 68% with CRSwNP, and 78% with RARS. On multivariate analysis, ETD improvement was associated with higher preoperative ETDQ-7 score (adjusted odds ratio [aOR], 1.12; 95% confidence interval [CI], 1.04-1.22; P = .030), higher preoperative SNOT-22 score (aOR, 1.02; 95% CI, 1.02-1.08; P = .001), higher preoperative SNOT-22 ear subscore (aOR, 1.27; 95% CI, 1.02-1.65; P = .034), posterior ethmoidectomy (aOR, 1.59; 95% CI, 1.22-4.92; P = .025), and postoperative corticosteroid spray use (aOR, 1.57; 95% CI, 1.17-1.66; P = .008). Conclusion ETD symptoms often improve following ESS. Factors associated with improvement include higher preoperative disease burden, posterior ethmoidectomy, and postoperative corticosteroid spray. Level of Evidence: 4

Endoscopic sinus surgery improves Eustachian tube function in patients with chronic rhinosinusitis: a multicenter prospective study

2021 ◽  
Vol 59 (6) ◽  
pp. 560-566
Author(s):  
X. Chen ◽  
H. Dang ◽  
Q. Chen ◽  
Z. Chen ◽  
Y. Ma ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Prospective Study ◽  
Eustachian Tube ◽  
Endoscopic Sinus Surgery ◽  
Valsalva Maneuver ◽  
Sinus Surgery ◽  
Eustachian Tube Function ◽  
Tube Dysfunction ◽  
Tube Function ◽  
Snot 22

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.

Predictors of eustachian tube dysfunction improvement and normalization after endoscopic sinus surgery

2019 ◽  
Vol 130 (12) ◽  
Author(s):  
Thomas S. Higgins ◽  
Zachary J. Cappello ◽  
Arthur W. Wu ◽  
Jonathan Y. Ting ◽  
Raj Sindwani
Keyword(s):  
Eustachian Tube ◽  
Endoscopic Sinus Surgery ◽  
Eustachian Tube Dysfunction ◽  
Sinus Surgery ◽  
Tube Dysfunction

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

2005 ◽  
Vol 19 (2) ◽  
pp. 199-202 ◽  
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.

Eustachian Tube Quality of Life and Severity of Disease in Patients With Chronic Rhinosinusitis

2020 ◽  
Vol 34 (4) ◽  
pp. 532-536 ◽  
Author(s):  
Arthur W. Wu ◽  
Evan S. Walgama ◽  
Thomas S. Higgins ◽  
Michela Borrelli ◽  
Narine Vardanyan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Eustachian Tube ◽  
Correlation Coefficients ◽  
Eustachian Tube Dysfunction ◽  
Spearman Correlation ◽  
Tube Dysfunction ◽  
The Mean ◽  
Snot 22

Background Chronic rhinosinusitis (CRS) has long been a suspected risk factor for Eustachian tube dysfunction (ETD). However, there have been few studies quantifying the presence of ETD in CRS patients. We sought to determine the prevalence of ETD symptoms in patients undergoing functional endoscopic sinus surgery (FESS) for CRS using the validated 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and to correlate the ETDQ-7 scores with scores of CRS symptom severity based on the 22-item Sino-Nasal Outcome Test (SNOT-22). Methods Patients for FESS were preoperatively administered both the ETDQ-7 and the SNOT-22 validated quality of life instruments. Pearson and Spearman correlation coefficients were calculated. Changes in ETDQ-7 were measured at 3 months and differences were compared via paired t test. Results A total of 82 patients completed the surveys. Thirty-nine (47.6%) patients had ETDQ-7 score ≥14.5, signifying clinically significant ETD symptoms. The mean ETDQ-7 score of the study population was 15.8 ± 8.8, and the mean SNOT-22 score was 37.5 ± 19.7. The Pearson and Spearman correlation coefficients between ETDQ-7 and the total SNOT-22 score were 0.52 ( P > .0001) and 0.51 ( P < .0001), respectively. There was significant improvement in ETDQ-7 scores postoperatively. Conclusion While the association between ETD and CRS has long been known, this is one of the few prospective patient studies evaluating otologic symptoms in a CRS population. We found that a significant percentage of CRS patients suffer from ETD symptoms based on patient-reported subjective outcome measures. This study demonstrates that otologic symptoms increase with CRS severity and improve after FESS.

Pneumocephalus and orbital emphysema associated with the use of an autoinflation device: a unique case report and review of the literature

2019 ◽  
Vol 133 (2) ◽  
pp. 157-160
Author(s):  
A J Millington ◽  
V Perkins ◽  
M A Salam
Keyword(s):  
Case Report ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Endoscopic Sinus Surgery ◽  
Otitis Media With Effusion ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Orbital Emphysema ◽  
Tube Dysfunction ◽  
History Of

AbstractBackgroundAutoinflation devices are commonly used for otitis media with effusion and Eustachian tube dysfunction. Generally, these are very safe devices, with few or no complications.Case reportThis paper presents a case study of pneumocephalus and orbital emphysema, associated with the use of an autoinflation device, in a 73-year-old woman with Eustachian tube dysfunction and otitis media with effusion, and a history of extensive endoscopic sinus surgery 13 years previously.ConclusionA literature review showed autoinflation-related pneumocephalus in patients with skull base defects relating to cranial surgery or tumours; however, this has not been described previously with the Otovent system or its use in relation to functional endoscopic sinus surgery. Given the theoretical risk of undetected bony abnormalities in post-operative functional endoscopic sinus surgery patients, it is suggested that autoinflation devices are used cautiously in patients with a history of sinus surgery.

scholarly journals Patient Reported Outcomes of Balloon Dilation for Eustachian Tube Dysfunction Using the SNOT-22 Survey

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Taufique Zahrah M ◽  
Gordon Steven A ◽  
Rotsides Janine M ◽  
Oliver Jamie R ◽  
Liberatore Lisa A
Keyword(s):  
Eustachian Tube ◽  
Patient Reported Outcomes ◽  
Balloon Dilation ◽  
Eustachian Tube Dysfunction ◽  
Patient Reported ◽  
Tube Dysfunction ◽  
Snot 22

scholarly journals Balloon dilation for eustachian tube dysfunction: systematic review

2016 ◽  
Vol 130 (S4) ◽  
pp. S2-S6 ◽  
Author(s):  
S Y Hwang ◽  
S Kok ◽  
J Walton
Keyword(s):  
Eustachian Tube ◽  
Balloon Dilation ◽  
Case Series ◽  
Eustachian Tube Dysfunction ◽  
Valsalva Manoeuvre ◽  
Potential Solution ◽  
Level Of Evidence ◽  
Tube Dysfunction ◽  
Prospective Case Series ◽  
Surgical Treatments

AbstractBackground:Eustachian tube dysfunction is a disorder for which there are limited medical and surgical treatments. Recently, eustachian tube balloon dilation has been proposed as a potential solution.Method:A systematic literature review was performed. Abstracts were selected for relevance, and pooled data analysis and qualitative analysis was conducted.Results:Nine prospective studies, describing 713 eustachian tube balloon dilations in 474 patients (aged 18–86 years), were identified. Follow-up duration ranged from 1.5 to 18 months. Ability to perform a Valsalva manoeuvre improved from 20 to 177 out of 245 ears following eustachian tube balloon dilation and, where data were reported in terms of patient numbers, from 15 to 189 out of 210 patients. Tympanograms were classified as type A in 7 out of 141 ears pre-operatively and in 86 out of 141 ears post-operatively.Conclusion:Prospective case series can confirm the safety of eustachian tube balloon dilation. As a potential solution for chronic eustachian tube dysfunction, further investigations are warranted to establish a higher level of evidence of efficacy.

Proof of concept study using a modified Politzer inflation device as a rescue modality for treating Eustachian tube dysfunction during hyperbaric oxygen treatment in a multiplace (Class A) chamber

2019 ◽  
pp. 55-61
Author(s):  
Owen J. O’Neill ◽  
Elizabeth Smykowski ◽  
Jo Ann Marker ◽  
Lubiha Perez ◽  
drah Gurash ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Dysfunction ◽  
Tube Placement ◽  
Treatment Schedule ◽  
Surgical Interventions ◽  
Hyperbaric Treatment ◽  
Middle Ear Pressure ◽  
Tube Dysfunction

Introduction: Eustachian tube dysfunction (ETD) and middle ear barotrauma (MEB) are the most common adverse effects of hyperbaric oxygen (HBO2) treatments. Patients practice equalization maneuvers to prevent ETD and MEB prior to hyperbaric exposure. Some patients are still unable to equalize middle ear pressure. This ETD results in undesirable consequences, including barotrauma, treatment with medications or surgical myringotomy with tube placement and interruption of HBO2. When additional medications and myringotomy are employed, they are associated with additional complications. Methods: A device known as the Ear Popper® has been reported to reduce complications from serous otitis media and reduce the need for surgical interventions (myringotomy). Patients unable to equalize middle ear pressure during initial compression in the hyperbaric chamber were allowed to use the device for rescue. All hyperbaric treatments were compressed using a United States Navy TT9, or a 45-fsw hyperbaric treatment schedule. Patients with persistent ETD and the inability to equalize middle ear pressure were given the Ear Popper upon consideration of terminating their treatment. Results: The Ear Popper allowed all patients to successfully equalize middle ear pressure and complete their treatments. Conclusion: This study substantiates the use of this device to assist in allowing pressurization of the middle ear space in patients otherwise unable to achieve equalization of middle ear pressure during HBO2 treatment in a multiplace chamber.

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