Effect of Functional Endoscopic Sinus Surgery on Eustachian Tube Function

Area of Science:

• Otolaryngology
• Rhinology
• Sino-nasal Diseases

Background:

• Eustachian tube dysfunction (ETD) frequently co-occurs with chronic rhinosinusitis (CRS).
• Assessing the impact of surgical intervention on ETD in CRS patients is crucial for comprehensive treatment planning.

Purpose of the Study:

• To evaluate the efficacy of functional endoscopic sinus surgery (FESS) in improving Eustachian tube function (ETF) among patients diagnosed with CRS.
• To identify patient subgroups who may benefit most from FESS regarding ETD.

Main Methods:

• A cohort of CRS patients undergoing bilateral primary FESS was assessed.
• Preoperative and postoperative evaluation of ETD utilized the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and a nine-step inflation/deflation tympanometric test.
• Patients were stratified into non-ETD (<14) and ETD (≥14) groups based on preoperative ETDQ-7 scores.

Main Results:

• Out of 66 patients, 26 were in the ETD group, exhibiting higher preoperative rhinosinusitis symptom scores (TWSNOT-22).
• Following FESS, the ETD group demonstrated a significant reduction in ETDQ-7 scores, with 61.54% recovering from ETD.
• While the nine-step test indicated poor preoperative ETF, it did not show significant improvement post-FESS.

Conclusions:

• FESS can lead to improved ETD in a subset of CRS patients.
• Patients with lower preoperative ETDQ-7 or University of Pennsylvania Smell Identification Test (UPSIT-TC) scores appear to be more likely to experience ETD improvement after FESS.