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.

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

scholarly journals Sinonasal Polyposis and Its Effect on Eustachian Tube Function

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.

Eustachian Tube Dysfunction in Allergic Rhinitis

2005 ◽  
Vol 132 (4) ◽  
pp. 626-629 ◽  
Author(s):  
Juan Gerardo Lazo-Sáenz ◽  
Armando Alejando Galván-Aguilera ◽  
Verónica Araceli Martínez-Ordaz ◽  
Víctor Manuel Velasco-Rodríguez ◽  
Armando Nieves-Rentería ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Eustachian Tube ◽  
Eustachian Tube Dysfunction ◽  
Control Group ◽  
Healthy Controls ◽  
Eustachian Tube Function ◽  
Skin Hypersensitivity ◽  
Tube Dysfunction ◽  
Tube Function ◽  
Middle Ear Disease

OBJECTIVE: To assess eustachian tube function in patients with allergic rhinitis and compare them with a control group. STUDY DESIGN AND SETTING: Tympanometry was performed in 130 patients (260 ears), divided into 2 groups: 80 cases with allergic rhinitis and 50 healthy controls. Cases underwent skin hypersensitivity tests. RESULTS: Cases, age 21.1 ± 14.9; Controls, age 23.9 ± 15.6. Most frequent skin hypersensitivity: Dermatophagoides pt (62%), Zea Maiz (44%), and Cockroach (37%). Tympanometry of cases showed negative values of peak tympanometric pressure in both children and adults ( P ≤ 0.05). Among children under 11 years of age, 15.5% tympanograms showed abnormal curves (13% C curves and 3% B curves); among the control group only normal curves were found (type A). CONCLUSION: Allergic rhinitis patients have a higher risk of eustachian tube dysfunction, particularly during childhood. Tympanometry is a noninvasive, readily available procedure that may be useful in these patients to prevent chronic middle-ear disease.

Measuring dynamic Eustachian tube function using tympanometry in a pressure chamber: the effect of nasal betahistine application

2019 ◽  
Vol 133 (7) ◽  
pp. 580-587 ◽  
Author(s):  
B K-H G Franz ◽  
R Patuzzi ◽  
C J Wraight ◽  
G Kay ◽  
A Ng ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Animal Studies ◽  
Pressure Chamber ◽  
Chamber Pressure ◽  
Eustachian Tube Function ◽  
Hyperbaric Chamber ◽  
Middle Ear Pressure ◽  
Tube Dysfunction ◽  
Tube Function

AbstractObjectiveTo assess the effect of topical betahistine on Eustachian tube function in subjectively abnormal subjects in a hyperbaric chamber.MethodActive and passive Eustachian tube function was examined using tympanometry in a pressure chamber.ResultsActive Eustachian tube function was tested against the negative middle ear pressure induced by increasing the chamber pressure to +3 kPa. One voluntary swallow decreased middle-ear pressure by a mean of 1.36 kPa. Passive Eustachian tube function was tested by measuring spontaneous Eustachian tube openings as the chamber pressure dropped from +10 kPa to ambient. Four distinct patterns of Eustachian tube behaviour were seen, three of which indicated Eustachian tube dysfunction. Betahistine had no positive effect on Eustachian tube opening, although previous animal studies had suggested a beneficial effect.ConclusionTopical betahistine had no effect on Eustachian tube function. Combining a hyperbaric chamber with tympanometry proved ideal for evaluating Eustachian tube function.

The efficacy of dynamic slow motion video endoscopy as a test of eustachian tube function

2013 ◽  
Vol 127 (7) ◽  
pp. 650-655 ◽  
Author(s):  
A M Augustine ◽  
L Varghese ◽  
R C Michael ◽  
R R Albert ◽  
A Job
Keyword(s):  
Eustachian Tube ◽  
Slow Motion ◽  
Eustachian Tube Dysfunction ◽  
Test Results ◽  
Eustachian Tube Function ◽  
Video Endoscopy ◽  
Clinically Normal ◽  
Tube Dysfunction ◽  
Tube Function ◽  
Motion Video

AbstractObjective:To assess the efficacy of dynamic slow motion video endoscopy as a test of eustachian tube function based on its correlation with the eustachian tube swallow test.Method:The eustachian tube swallow test and dynamic slow motion video endoscopy were performed on 100 clinically normal middle ears of adults undergoing rigid nasal endoscopy for various indications. The dynamic slow motion video endoscopy findings were interpreted by three observers who were blind to the results of the eustachian tube swallow test, and the findings of both techniques were compared.Results:There was a statistically significant correlation between the dynamic slow motion video endoscopy and eustachian tube swallow test results for some of the more lenient criteria. Five of the 100 eustachian tubes had a floppy medial cartilaginous lamina which appeared to contribute to the eustachian tube dysfunction.Conclusion:Dynamic slow motion video endoscopy appeared to over-diagnose eustachian tube dysfunction when used as a standalone test of eustachian tube function. However, when used in combination with other tests of eustachian tube function, it can provide valuable information regarding the structural and functional status of the pharyngeal end of the eustachian tube.

The Face in Otitis Media

PEDIATRICS ◽  
1985 ◽  
Vol 75 (1) ◽  
pp. 131-131
Author(s):  
GAIL G. SHAPIRO
Keyword(s):  
Eustachian Tube ◽  
Growth Pattern ◽  
Hypersensitivity Reactions ◽  
Eustachian Tube Function ◽  
Facial Growth ◽  
Limited Evidence ◽  
Tube Dysfunction ◽  
Tube Function ◽  
The Face ◽  
Growth Abnormalities

In Reply.— Sharon's impression that children with a specific facies might be more prone to otitis, if true, might mean that there is an association between certain facial growth pattern and aberrant Eustachian tube function. Along the same lines, there is limited evidence and much discussion about the incidence of ear problems being higher in allergic children; their Eustachian tubes are compromised by the changes induced by hypersensitivity reactions in the contiguous area. As intimated by Sharon, perhaps the sequelae of chronic rhinitis are twofold: facial growth abnormalities and Eustachian tube dysfunction.

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
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