Ma Yun, Liang Maojin, Tian Peng, Liu Xiang, Dang Hua, Chen Qiujian, Zou Hua, Zheng Yiqing
Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Clin Transl Allergy. 2020 Jul 15;10:30. doi: 10.1186/s13601-020-00328-9. eCollection 2020.
One of the important pathogeneses of eustachian tube dysfunction (ETD) is nasal inflammatory disease. The prevalence of allergic rhinitis (AR) in adults ranges from 10 to 30% worldwide. However, research on the status of eustachian tubes in AR patients is still very limited.
This prospective controlled cross-sectional study recruited 59 volunteers and 59 patients with AR from Sun Yat-sen Memorial Hospital. Visual analogue scale (VAS) scores for AR symptoms and seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores were collected for both groups. Nasal endoscopy, tympanography and eustachian tube pressure measurement (tubomanometry, TMM) were used for objective assessment. All AR patients underwent 1 month of treatment with mometasone furoate nasal spray and oral loratadine. Then, the nasal condition and eustachian tube status were again evaluated.
TMM examination revealed that 22 patients (39 ears, 33.1%) among the AR patients and 5 healthy controls (7 ears, 5.9%) had abnormal eustachian pressure. Twenty-two AR patients (37.3%) and 9 healthy controls had an ETDQ-7 score ≥ 15. With regard to nasal symptoms of AR, the VAS scores of nasal obstruction were correlated with the ETDQ-7 scores, and the correlation coefficient was r = 0.5124 (< 0.0001). Nasal endoscopic scores were also positively correlated with ETDQ-7 scores, with a correlation coefficient of 0.7328 (< 0.0001). After 1 month of treatment, VAS scores of nasal symptoms, endoscopic scores and ETDQ-7 scores were significantly decreased in AR patients (< 0.0001), and TMM examination also suggested that eustachian tube function was significantly improved after treatment (< 0.0001).
AR patients, especially those with severe nasal obstruction, could have ETD. The local conditions of the pharyngeal orifices of the eustachian tubes are closely related to the symptoms of ETD. After treatment with nasal glucocorticoids and oral antihistamines, eustachian tube function can significantly improve as nasal symptoms subside. Chinese Clinical Trial Registery (ChiCTR2000029071) Registered 12 January 2020-Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=48328&htm=4.
咽鼓管功能障碍（ETD）的重要发病机制之一是鼻腔炎症性疾病。全球范围内成人过敏性鼻炎（AR）的患病率在10%至30%之间。然而，关于AR患者咽鼓管状况的研究仍然非常有限。
这项前瞻性对照横断面研究从中山大学孙逸仙纪念医院招募了59名志愿者和59名AR患者。收集两组患者的AR症状视觉模拟量表（VAS）评分和七项咽鼓管功能障碍问卷（ETDQ - 7）评分。采用鼻内镜检查、鼓室导抗图和咽鼓管压力测量（咽鼓管测压，TMM）进行客观评估。所有AR患者接受1个月的糠酸莫米松鼻喷雾剂和口服氯雷他定治疗。然后，再次评估鼻腔状况和咽鼓管状况。
TMM检查显示，AR患者中有22例（39耳，33.1%）和5名健康对照者（7耳，5.9%）咽鼓管压力异常。22例AR患者（37.3%）和9名健康对照者的ETDQ - 7评分≥15。关于AR的鼻腔症状，鼻塞的VAS评分与ETDQ - 7评分相关，相关系数r = 0.5124（<0.0001）。鼻内镜评分也与ETDQ - 7评分呈正相关，相关系数为0.7328（<0.0001）。治疗1个月后，AR患者的鼻腔症状VAS评分、内镜评分和ETDQ - 7评分均显著降低（<0.0001），TMM检查也表明治疗后咽鼓管功能显著改善（<0.0001）。
AR患者，尤其是鼻塞严重的患者，可能存在ETD。咽鼓管咽口的局部状况与ETD症状密切相关。经鼻用糖皮质激素和口服抗组胺药治疗后，随着鼻腔症状减轻，咽鼓管功能可显著改善。中国临床试验注册中心（ChiCTR2000029071）于2020年1月12日注册——回顾性注册，http://www.chictr.org.cn/edit.aspx?pid=48328&htm=4 。
