Abstract
BackgroundOne of the important pathogeneses of eustachian tube dysfunction (ETD) is nasal inflammatory disease. The prevalence of allergic rhinitis (AR) in adults ranges from 10 to 30% worldwide. However, research on the status of eustachian tubes in AR patients is still very limited.MethodsThis prospective controlled cross-sectional study recruited 59 volunteers and 59 patients with AR from Sun Yat-sen Memorial Hospital. Visual analogue scale (VAS) scores for AR symptoms and seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores were collected for both groups. Nasal endoscopy, tympanography and eustachian tube pressure measurement (tubomanometry, TMM) were used for objective assessment. All AR patients underwent 1 month of treatment with mometasone furoate nasal spray and oral loratadine. Then, the nasal condition and eustachian tube status were again evaluated.ResultsTMM examination revealed that 22 patients (39 ears, 33.1%) among the AR patients and 5 healthy controls (7 ears, 5.9%) had abnormal eustachian pressure. Twenty-two AR patients (37.3%) and 9 healthy controls had an ETDQ-7 score ≥ 15. With regard to nasal symptoms of AR, the VAS scores of nasal obstruction were correlated with the ETDQ-7 scores, and the correlation coefficient was r = 0.5124 (p < 0.0001). Nasal endoscopic scores were also positively correlated with ETDQ-7 scores, with a correlation coefficient of 0.7328 (p < 0.0001). After 1 month of treatment, VAS scores of nasal symptoms, endoscopic scores and ETDQ-7 scores were significantly decreased in AR patients (p < 0.0001), and TMM examination also suggested that eustachian tube function was significantly improved after treatment (p < 0.0001).ConclusionsAR patients, especially those with severe nasal obstruction, could have ETD. The local conditions of the pharyngeal orifices of the eustachian tubes are closely related to the symptoms of ETD. After treatment with nasal glucocorticoids and oral antihistamines, eustachian tube function can significantly improve as nasal symptoms subside.Trial registration Chinese Clinical Trial Registery (ChiCTR2000029071) Registered 12 January 2020—Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=48328&htm=4
Highlights
One of the important pathogeneses of eustachian tube dysfunction (ETD) is nasal inflammatory disease
The inclusion criteria included (1) clinical symptoms of allergic rhinitis (AR) evidenced by nasal obstruction, itching, sneezing and watery rhinorrhoea; (2) pale nasal mucosa, watery secretions or inferior turbinate hypertrophy; and (3) a positive skin prick test (SPT) for house dust mite or specific immunoglobulin E to Dermatophagoides pteronyssinus (Der p1)
Prevalence of ETD in patients with AR The Seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) was used to evaluate the subjective symptoms of ETD
Summary
One of the important pathogeneses of eustachian tube dysfunction (ETD) is nasal inflammatory disease. The prevalence of allergic rhinitis (AR) in adults ranges from 10 to 30% worldwide. Research on the status of eustachian tubes in AR patients is still very limited. Eustachian tube dysfunction (ETD) is estimated to affect 1% of adults and 40% of children [1,2,3]. Ma et al Clin Transl Allergy (2020) 10:30 inflammatory conditions. Smoking, chronic rhinosinusitis (CRS), allergic rhinitis (AR) and laryngopharyngeal reflux [4] have been proposed as potential contributing factors affecting eustachian tube function [5]. Some studies have shown that the incidence of ETD in CRS patients is 48.5–68% [6, 7]
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