Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Rhinology. 2021 Dec 1;59(6):560-566. doi: 10.4193/Rhin21.209.
Patients with chronic rhinosinusitis (CRS) often have Eustachian tube dysfunction (ETD) symptoms. This study aimed to prospectively investigate the effect of endoscopic sinus surgery (ESS) on improvement of Eustachian tube function in CRS patients with ETD from a Chinese population and determine factors associated with improvement.
A prospective study was performed in CRS patients with ETD who underwent ESS from 3 tertiary medical centers in south China. The Eustachian tube Dysfunction Questionnaire 7 (ETDQ-7), Sinonasal Outcome Test 22 (SNOT-22), tympanograms, endoscopic findings and Valsalva maneuver were recorded and analyzed preoperatively and postoperatively at 8-12 weeks.
A total of 70 CRS patients with ETD were included in this study. The ETDQ-7 score and the ability of positive Valsalva maneuver in CRS patients were significantly improved postoperatively at 8-12 weeks. The number of patients with type A tympanogram was increased postoperatively. Reduced Eustachian tube mucosal inflammation was also observed postoperatively. In addition, ESS appeared to reverse slight tympanic membrane atelectasis after 8-12 weeks. Moreover, improvement in tympanogram was presented in more than half of CRS patients with concomitant otitis media with effusion postoperatively at 8-12 weeks. Univariate and multivariate analysis revealed failure of normalization of ETDQ-7 postoperatively was associated with concomitant allergic rhinitis and higher preoperative SNOT-22 score.
This study confirms Eustachian tube function is often improved after ESS in CRS patients with ETD. Concomitant allergic rhinitis and higher preoperative SNOT-22 score are associated with failure of normalization of ETD symptoms.
慢性鼻-鼻窦炎（CRS）患者常伴有咽鼓管功能障碍（ETD）症状。本研究旨在前瞻性调查内镜鼻窦手术（ESS）对中国人群中 ETD 合并 CRS 患者咽鼓管功能改善的影响，并确定与改善相关的因素。
对 3 家中国南方三级医疗中心接受 ESS 的 ETD 合并 CRS 患者进行前瞻性研究。在术前和术后 8-12 周记录和分析 Eustachian 管功能障碍问卷 7（ETDQ-7）、鼻-鼻窦结局测试 22（SNOT-22）、鼓室图、内镜检查结果和瓦尔萨尔瓦动作。
本研究共纳入 70 例 ETD 合并 CRS 患者。术后 8-12 周，CRS 患者的 ETDQ-7 评分和正压瓦尔萨尔瓦动作能力明显改善，A型鼓室图的患者数量增加，咽鼓管黏膜炎症减轻。此外，术后 8-12 周还观察到鼓膜轻微萎陷得到逆转。此外，术后 8-12 周，伴有分泌性中耳炎的 CRS 患者中，超过一半的患者鼓室图得到改善。单因素和多因素分析显示，术后 ETDQ-7 无法正常化与合并变应性鼻炎和术前 SNOT-22 评分较高有关。
本研究证实 ESS 后 ETD 合并 CRS 患者咽鼓管功能常得到改善。合并变应性鼻炎和较高的术前 SNOT-22 评分与 ETD 症状无法正常化有关。
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