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Effect of Functional Endoscopic Sinus Surgery on Eustachian Tube Function.

Wan-Cian Lin^1,2, Jing-Jie Wang^2,3, Rong-San Jiang^4,5,6

¹Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.

The Laryngoscope

|December 2, 2025

Summary

Functional endoscopic sinus surgery (FESS) may improve Eustachian tube dysfunction (ETD) in some chronic rhinosinusitis (CRS) patients. Improvement was noted in those with lower preoperative scores on the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) or smell identification tests.

Keywords:

Eustachian Tube Dysfunction Questionnaire Eustachian tube function chronic rhinosinusitis functional endoscopic sinus surgery nine‐step inflation/deflation tympanometric Eustachian tube function test

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Published on: May 23, 2021

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.