Abstract
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.
Highlights
The paranasal sinuses and nasal cavity are situated proximate with the middle ear, and connected to it by the eustachian tube (E-tube)
Stoikes and Dutton reported that E-tube dysfunction is common in patients with chronic sinusitis undergoing endoscopic sinus surgery (ESS), and that the symptoms resolved after the surgery [6]
Polyps were noted in 22 cases, fungal balls were found in 7 cases, sinusitis of dental origin was 2 cases, and no case was diagnosed with ciliary dyskinesia or mucoviscidosis
Summary
The paranasal sinuses and nasal cavity are situated proximate with the middle ear, and connected to it by the eustachian tube (E-tube). Diseases in these areas can affect each other, and it is not uncommon to meet patients in clinical practice with diseases in both nose and ear. Direct flow of the postnasal drip in paranasal sinusitis into the E-tube can give rise to diseases in the E-tube or the middle ear [2,3]. The reported studies on the relationship of sinusitis and E-tube function in adult patients are not based on the objective measurement of the E-tube function but questionnaires or analyses of previous studies. While E-tube dysfunction has been recognized as an important comorbidity associated with chronic sinusitis, a significant relationship between
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