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Should Nasal Function be Considered Prior to Tympanoplasty?

Metin Yüksel Akyıldız1, Ömer Afşın Özmen2, Uygar Levent Demir2

  • 1Department of Otolaryngology, Darende State Hospital, Malatya, Turkey.

The Journal of International Advanced Otology
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Patients with chronic suppurative otitis media (CSOM) and nasal septal deviation (NSD) often have poor Eustachian tube (ET) function, but this does not impact tympanoplasty outcomes. Preoperative ET function does not predict the need for septoplasty.

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Area of Science:

  • Otolaryngology
  • Rhinology
  • Surgical Outcomes

Background:

  • Chronic suppurative otitis media (CSOM) affects Eustachian tube (ET) function.
  • Nasal airway obstruction, such as nasal septal deviation (NSD), may influence ET function.
  • Understanding these relationships is crucial for optimizing tympanoplasty outcomes.

Purpose of the Study:

  • To investigate the association between nasal airway function and ET function in patients with CSOM.
  • To assess the impact of these functions on tympanoplasty outcomes.
  • To determine if preoperative ET function predicts the need for septal surgery.

Main Methods:

  • Compared nasal and ET functions in 33 CSOM patients undergoing tympanoplasty, 25 NSD patients, and 25 healthy controls.
  • Utilized acoustic rhinometry, rhinomanometry, and tympanometry (Williams test and pressure equalization test).
  • Re-evaluated ET function 3 months post-tympanoplasty.

Main Results:

  • CSOM and NSD groups exhibited poorer nasal function compared to controls.
  • CSOM patients had the most impaired ET function preoperatively.
  • ET function improved post-tympanoplasty, with no significant differences between groups at 3 months.
  • Nasal function did not affect tympanoplasty success (90% graft take rate).

Conclusions:

  • While NSD is associated with poor ET function, it does not negatively impact tympanoplasty results.
  • Preoperative ET function is not a reliable predictor for septoplasty necessity.
  • Surgical correction of NSD before tympanoplasty should be individualized, not universally recommended.