Effect of Functional Endoscopic Sinus Surgery on Eustachian Tube Function

Eustachian tube dysfunction (ETD) is a common comorbidity in chronic rhinosinusitis (CRS). This study aims to investigate the effect of functional endoscopic sinus surgery (FESS) on Eustachian tube function (ETF) in patients with CRS.

CRS patients who had undergone bilateral primary FESS were collected. The severity of rhinosinusitis was evaluated by questionnaires (TWSNOT-22), nasal endoscopy, computed tomography, acoustic rhinometry, olfactory tests, and saccharine transit time test. The Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and the nine-step inflation/deflation tympanometric ETF test (nine-step test) were applied to assess ETF. They were classified into non-ETD (< 14) and ETD (≥ 14) according to their preoperative ETDQ-7 scores. The effect of FESS on ETF was investigated by postoperative change of ETDQ-7 and the nine-step test.

Among the 66 included patients, 40 were classified into the non-ETD group and 26 into the ETD group. The median ETDQ-7 score was 8.00 in the non-ETD group and 18.00 in the ETD group. In the ETD group, the preoperative TWSNOT-22 score was significantly higher. Following FESS, the ETDQ-7 score decreased significantly in the ETD group. Sixteen (61.54%) patients in the ETD group recovered from ETD and had lower preoperative scores for ETDQ-7 and the traditional Chinese version of the University of Pennsylvania Smell Identification Test (UPSIT-TC). The nine-step test showed poor preoperative ETF in the ETD group, but did not demonstrate a significant improvement in ETF after FESS.

FESS might improve ETD in a subset of CRS patients with lower preoperative ETDQ-7 or UPSIT-TC scores.