Choi Kyu Young, Jang Sookyung, Seo Ganghyeon, Park Su-Kyoung
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Kangnam Sacred Heart Hospital, Hallym University, Seoul 07441, Korea.
J Clin Med. 2021 Oct 13;10(20):4689. doi: 10.3390/jcm10204689.
The eustachian tube (E-tube) function is known to be related with sinusitis; however, the effect of endoscopic sinus surgery (ESS) on E-tube function is not clearly documented. This study aimed to prospectively evaluate the function of the E-tube by using both subjective and objective tests in adult chronic sinusitis patients undergoing ESS, and to compare with those of the patients without sinusitis. Thirty adult patients who underwent ESS for treatment of chronic sinusitis and another thirty patients without sinusitis who underwent other nasal surgeries (septoplasty, rhinoplasty, or closed reduction) were evaluated and compared for E-tube function before and after three months of their surgeries. The E-tube function tests included the seven-item eustachian tube dysfunction questionnaire (ETDQ-7), Valsalva test, and inflation-deflation test that were compared preoperatively and postoperatively in both groups. Compared with the group without sinusitis, the ESS group showed significant improvement of E-tube function after surgery in the ETDQ-7 ( = 0.002), right Valsalva test ( = 0.015), right deflation test ( = 0.005), and left deflation test ( = 0.006). A binary logistic regression analysis revealed that ESS significantly improved E-tube function in the right Valsalva test in a univariate ( = 0.021) and multivariate analysis ( = 0.008), and E-tube function in the left deflation test in a univariate ( = 0.021) and multivariate analysis ( = 0.039). These findings indicate that E-tube function is significantly improved after ESS in adult sinusitis patients, and that the presence of sinusitis and implementation of ESS should be considered (if sinusitis is present) in managing patients with ear diseases that are affected by E-tube function.
已知咽鼓管功能与鼻窦炎有关；然而，内镜鼻窦手术（ESS）对咽鼓管功能的影响尚无明确记录。本研究旨在通过主观和客观测试，对接受ESS的成年慢性鼻窦炎患者的咽鼓管功能进行前瞻性评估，并与无鼻窦炎患者进行比较。对30例因慢性鼻窦炎接受ESS治疗的成年患者和另外30例无鼻窦炎但接受其他鼻部手术（鼻中隔成形术、鼻整形术或闭合复位术）的患者，在手术前及术后三个月评估并比较其咽鼓管功能。咽鼓管功能测试包括七项咽鼓管功能障碍问卷（ETDQ-7）、瓦尔萨尔瓦试验和充放气试验，两组患者在术前和术后均进行比较。与无鼻窦炎组相比，ESS组在ETDQ-7（P = 0.002）、右侧瓦尔萨尔瓦试验（P = 0.015）、右侧放气试验（P = 0.005）和左侧放气试验（P = 0.006）中术后咽鼓管功能有显著改善。二元逻辑回归分析显示，在单因素分析（P = 0.021）和多因素分析（P = 0.008）中，ESS显著改善了右侧瓦尔萨尔瓦试验中的咽鼓管功能，在单因素分析（P = 0.021）和多因素分析（P = 0.039）中，ESS显著改善了左侧放气试验中的咽鼓管功能。这些发现表明，成年鼻窦炎患者ESS后咽鼓管功能显著改善，在管理受咽鼓管功能影响的耳部疾病患者时，应考虑鼻窦炎的存在及ESS的实施（如果存在鼻窦炎）。
