This is a prospective study from the UK looking at Eustachian tube dysfunction (ETD) in patients with chronic rhinosinusitis (CRS) undergoing surgery. Fifty-seven consecutive patients who had failed medical therapy and were scheduled for endoscopic sinus surgery completed SNOT-22 and ETDQ-7 questionnaires and had Valsalva assessment with tympanometry preoperatively at three and six months. A standard approach was used for assessment and the same audiologist recorded the tympanometry. The same surgeon performed all procedures, however it is not stated whether any patients also underwent septoplasty or turbinate surgery. Statistical analysis was appropriate and ethical considerations mentioned. There was a moderate preoperative positive correlation between the SNOT-22 and ETDQ-7 scores, Spearman rank co-efficient 0.57.
Sixty-eight percent (n=39) of patients recorded an ETDQ-7 score suggestive of Eustachian tube dysfunction prior to surgery, mean 20.6 (SD+/-10.34). The score for CRS with nasal polyps was 24.34 (n=23) and for CRS without polyps 18.11 (n=34). The mean ETDQ-7 score was significantly lower at three months 11.4 (SD+/-5.65) (n=51) and at nine months 11.4(SD+/-6.15) (n=26).
Type A tympanograms increased from 76.6% (n=114) to 94.5% at three months (n=92) and 96% (n=52) at nine months. An effective Valsalva also increased from 38% to 96% at three and nine months. The study supports a high incidence of ETD in severe CRS patients whose symptoms improved after endoscopic sinus surgery, as documented by SNOT-22, ETDQ-7, tympanometry and Valsalva.
