School of Medicine.
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA.
Int Forum Allergy Rhinol. 2019 May;9(5):466-472. doi: 10.1002/alr.22275. Epub 2019 Jan 15.
Sinonasal pathology is frequently cited as a cause of eustachian tube dysfunction (ETD), despite a lack of evidence. Using a large, nationally representative sample, we investigated whether abnormal tympanometry, an objective marker of ETD, was associated with infectious, allergic, and exposure-related sinonasal risk factors.
Relevant data were extracted from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). Tympanometric types (A, B, and C) were determined using peak pressure and compliance values. Participants with a type B or C tympanogram in at least one ear were classified as having ETD. Demographic and clinicopathologic risk factors with putative associations with ETD were determined. Statistical analysis, including regression modeling, was performed using Stata (version 15.1) to determine the correlation between sinonasal factors and ETD.
The final analysis included 1253 subjects and 19 variables. We controlled for demographic data including age, gender, race, and income. In both univariate and multivariate logistic regression, statistically significant correlations were found between abnormal tympanometric values and: (1) having a persistent cold/flu in the last 12 months (univariate: adjusted odds ratio [OR], 2.42; p = 0.006; multivariate: adjusted OR, 2.15; p = 0.006); and (2) experiencing "hay fever" (ie, allergic rhinitis) within the last 12 months (univariate: adjusted OR, 1.95; p = 0.021; multivariate: adjusted OR, 1.71; p = 0.039).
Using a large, representative data set, we identified significant correlations between ETD and (1) persistent cold/flu symptoms and (2) self-reported allergic rhinitis.
尽管缺乏证据,但鼻-鼻窦疾病常被认为是咽鼓管功能障碍(ETD)的原因。本研究使用大型全国代表性样本,调查了客观的 ETD 标志物——鼓室压图异常是否与感染性、变应性和与暴露相关的鼻-鼻窦危险因素有关。
从 2011-2012 年国家健康和营养调查(NHANES)中提取相关数据。使用峰压和顺应性值确定鼓室压图类型(A、B 和 C)。至少一侧鼓室压图为 B 型或 C 型的患者被归类为患有 ETD。确定与 ETD 有潜在关联的人口统计学和临床病理危险因素。使用 Stata(版本 15.1)进行统计学分析,包括回归建模,以确定鼻-鼻窦因素与 ETD 之间的相关性。
最终分析纳入 1253 名受试者和 19 个变量。我们控制了人口统计学数据,包括年龄、性别、种族和收入。在单变量和多变量逻辑回归中,异常鼓室压值与以下因素之间存在统计学显著相关性:(1)过去 12 个月内持续出现感冒/流感(单变量:调整后的优势比[OR],2.42;p = 0.006;多变量:调整后的 OR,2.15;p = 0.006);(2)过去 12 个月内患有“花粉热”(即变应性鼻炎)(单变量:调整后的 OR,1.95;p = 0.021;多变量:调整后的 OR,1.71;p = 0.039)。
本研究使用大型代表性数据集,确定了 ETD 与(1)持续感冒/流感症状和(2)自我报告的变应性鼻炎之间存在显著相关性。