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Interplay Between Rhinosinusitis and Eustachian Tube Dysfunction in Patients Undergoing Functional Endoscopic Sinus

Jing-Jie Wang^1,2, Chien-Hsiang Weng³, Yi-Ting Yao¹

¹Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery

|May 22, 2026

Summary

Chronic rhinosinusitis (CRS) shows a moderate link to patient-reported Eustachian tube dysfunction (ETD). Higher symptom scores in CRS correlate with worse ETD, suggesting patient-reported outcome measures can identify ETD influenced by CRS.

Keywords:

Bluestone nine‐step test Eustachian tube dysfunction Eustachian tube dysfunction questionnaire‐7 Lund‐Mackay system acoustic rhinometry chronic rhinosinusitis lateralized impact modified Lund‐Kennedy system sinonasal symptoms sino‐nasal outcome test‐22

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Area of Science:

Otolaryngology
Rhinology
Audiology

Background:

Chronic rhinosinusitis (CRS) is a prevalent inflammatory condition affecting the sinonasal pathways.
Eustachian tube dysfunction (ETD) can significantly impact quality of life, often co-occurring with upper airway diseases.
Understanding the relationship between CRS and ETD is crucial for comprehensive patient management.

Purpose of the Study:

To investigate the association between chronic rhinosinusitis (CRS) and Eustachian tube dysfunction (ETD).
To utilize both subjective and objective measures to assess this relationship.
To explore the impact of disease laterality on Eustachian tube function (ETF) in CRS patients.

Main Methods:

A prospective cohort study involving 85 CRS patients undergoing FESS.
Subjective assessment using the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) and Sino-Nasal Outcome Test-22 (SNOT-22).
Objective evaluations included tympanometry (MPD), nasal endoscopy (MLK), sinus CT (LM), and acoustic rhinometry (MCA2).

Main Results:

36.5% of CRS patients exhibited poor Eustachian tube function (ETDQ-7 ≥ 14), correlating with higher SNOT-22 scores (P < .001).
A moderate correlation was found between ETDQ-7 and SNOT-22 (r = 0.65).
No significant objective differences (MPD, MLK, LM, MCA2) were observed between fair and poor ETF groups; laterality showed no significant association.

Conclusions:

Patient-reported sinonasal symptom burden is moderately associated with patient-reported ETD in CRS.
Elevated ETDQ-7 scores often align with increased SNOT-22 severity.
Patient-Reported Outcome Measures (PROMs) may help identify CRS patients with ETD symptoms partly influenced by their sinonasal condition.