Submucous resection. The treatment of choice in the nose-ear distress syndrome

The combination of nasal septal deviation and Eustachian tube dysfunction, in the absence of any other pathology, constitutes the Nose-Ear Distress Syndrome. We have undertaken a clinical assessment of the relationship between uncomplicated deviation of the nasal septum and Eustachian tube dysfunction in Naval Personnel who are serving in environments of primarily increased barometric pressure. 120 candidates to the Submarine, Diving and Aircrew branches of the Royal Navy who presented with the Nose-Ear distress syndrome were initially surveyed. None were able to equilibrate their middle ear pressures at an increased ambient pressure of 3 metres of water. Submucous resection was performed on 116, of whom 110 (94.83 per cent) were able to equilibrate their middle ear pressures at an increased ambient pressure of 9 metres of water post-operatively. Xenon 133 Scintigraphy was performed on a further 25 recruits to delineate the post-nasal airflow. This investigation was performed pre- and post-operatively. Pre-operatively, Scintigraphy showed the presence of turbulence in the post-nasal space, while post-operatively the turbulence was absent. All the candidates were unable to equilibrate their middle ear pressures pre-operatively, but after submucous resection 24 (96 per cent) were able to equilibrate their middle ear pressures at an increased barometric pressure of 9 metres of water.