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Effects of nasal packing on eustachian tube function
Archives of Otolaryngology (Chicago, Ill. : 1960)
|September 1, 1977
Summary
Posterior nasal packing significantly impairs eustachian tube function more than anterior packing. This suggests lymphatic stasis, not just nasal obstruction, causes middle ear pressure changes.
Area of Science:
- Otolaryngology
- Nasal and Sinus Surgery
- Auditory Physiology
Background:
- Nasal packing is a common post-operative and epistaxis management technique.
- Eustachian tube dysfunction can lead to middle ear pathologies.
- The impact of different nasal packing types on eustachian tube function is not fully elucidated.
Purpose of the Study:
- To evaluate and compare the effects of anterior and combined anterior-posterior nasal packing on eustachian tube function.
- To investigate the incidence of middle ear pressure changes associated with nasal packing.
Main Methods:
- Tympanometry was used to assess eustachian tube function.
- Study included 47 patients (94 ears) with anterior nasal packing.
- Included 12 patients (24 ears) with anterior and posterior packing for epistaxis.
Main Results:
- 25.5% of ears with anterior packing showed reduced middle ear pressure (≥ -100 mm H2O).
- 92.3% of ears ipsilateral to posterior packing and 45.4% contralateral showed reduced middle ear pressure.
- Posterior packing demonstrated a significantly higher incidence of eustachian tube dysfunction.
Conclusions:
- Posterior nasal packing is associated with a greater incidence of eustachian tube dysfunction compared to anterior packing.
- The findings suggest that lymphatic stasis in the peritubal lymphatic plexus may be the primary mechanism, rather than nasal obstruction alone.