Impact of Nasal Obstruction Surgeries on Eustachian Tube Function and Middle Ear Ventilation - A Prospective Hospital-Based Study

Abstract

Background: Nasal obstruction is a common condition caused by various aetiologies, including deviated nasal septum, nasal polyps, and chronic rhinosinusitis. This condition can adversely affect the Eustachian tube function, leading to impaired middle ear ventilation, negative middle ear pressure, and associated symptoms such as ear fullness, discomfort, and hearing loss. Surgical intervention to correct nasal obstruction has been shown to improve Eustachian tube function and middle ear ventilation potentially, but comprehensive studies on this impact remain limited.

Objective: To evaluate the impact of nasal obstruction surgeries on Eustachian tube function and middle ear ventilation in patients undergoing these procedures.

Methods: This prospective hospital-based study included 60 patients (120 ears) aged 18 years and older who underwent nasal obstruction surgeries. The NOSE (Nasal Obstruction Symptom Evaluation) score was utilised to assess the subjective perception of nasal symptoms. Eustachian tube function tests, including the Valsalva and Toynbeeinduced tympanometry, were conducted preoperatively and then after surgery at 8 weeks to measure middle ear pressure. Statistical analysis was performed using SPSS software, version 23.0, with p-values < 0.05 considered statistically significant.

Results: The postoperative NOSE scores showed significant improvement compared to preoperative scores [2.83 ± 2.86 versus 10.43 ± 4.08; p < 0.001]. In the 84 ears of patients with deviated nasal septum (42 patients), postoperative Type A tympanograms and Eustachian tube function tests were significantly better than preoperative results [71 (84.5%) versus 58 (69%); p = 0.038] and [69 (82.1%) versus 38 (45.2%); p < 0.001], respectively. Among the 36 ears of patients with chronic rhinosinusitis with nasal polyposis (18 patients), postoperative Type A tympanograms and Eustachian tube function tests also showed significant improvement from the preoperative ones [30 (83.3%) versus 21 (58.3%); p < 0.05] and [28 (77.7%) versus 17 (47.2%); p < 0.05], respectively. Overall, in the 120 ears of patients, a significant decrease in negative middle ear pressure was observed in 34 out of 60 ears post-surgery (p < 0.001).

Conclusion: Nasal obstruction surgeries significantly improve Eustachian tube function and middle ear ventilation, leading to better middle ear pressure regulation and relief from related symptoms. These findings underscore the importance of addressing nasal obstructions to enhance overall ear health in affected patients.