Predictors of eustachian tube dysfunction improvement and normalization after endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Rhinology
• Symptomology

Background:

• Eustachian tube dysfunction (ETD) symptoms can improve after functional endoscopic sinus surgery (FESS).
• Factors influencing ETD symptom changes post-FESS require elucidation.
• Understanding these factors can optimize patient outcomes.

Purpose of the Study:

• To identify factors associated with improvement and normalization of ETD symptoms after FESS.
• To evaluate the impact of various clinical parameters on ETD symptom resolution post-surgery.

Main Methods:

• A case-control study compared FESS patients with normalized ETD symptoms (ETDQ-7) to those without normalization.
• Preoperative data included demographics, chronic rhinosinusitis phenotype, Lund-Mackay score, temporomandibular joint dysfunction (TMJD), ETDQ-7, SNOT-22, and tympanometry.
• Univariate and multivariate analyses were conducted.

Main Results:

• FESS improved both SNOT-22 and ETDQ-7 scores (P < 0.001).
• Nasal polyposis was linked to a higher likelihood of ETDQ-7 normalization (OR 4.429, P = 0.035).
• TMJD (OR 0.086, P < 0.001) and high preoperative ETDQ-7 (OR 0.140, P = 0.006) were associated with failure to normalize.

Conclusions:

• FESS improves ETD symptoms in patients without middle ear effusion.
• Nasal polyposis positively influences postoperative ETD symptom normalization.
• Temporomandibular joint dysfunction negatively impacts ETD symptom resolution after FESS.