Eustachian tube symptoms are frequent in chronic rhinosinusitis and respond well to endoscopic sinus surgery

Abstract

Background: Symptoms of Eustachian tube (ET) dysfunction are seldom assessed in patients with chronic rhinosinusitis (CRS). The Sino-Nasal Outcome Test (SNOT-22) quality-of-life tool includes two questions that specifically screen for symptoms of ET dysfunction (‘Ear Fullness’; ‘Ear Pain’). Objective: The purpose of this study was to determine the extent to which these ET symptoms were present in patients with CRS, and whether these symptoms respond to endoscopic sinus surgery (ESS). Methodology: SNOT-22 data collected prospectively at time of recruitment into IRB-approved clinical trials or case-control studies in CRS was pooled to provide a cross section of the frequency and severity of ET dysfunction. When applicable to the trials, the SNOT-22 was repeated at least 3 months following ESS. Results: Five trials rendering 131 patients were available for assessment. The control group comprised of 251 participants from two case-control studies. ‘Ear Fullness’ of ≥1 was reported in 80/131 CRS patients compared to 45/251 control patients. ‘Ear Pain’ of ≥1 was reported in 39/131 CRS patients compared to 33/251 control patients. Following ESS, mean ‘Ear Fullness’ and ‘Ear Pain’ scores decreased to 1.17 and 0.73, respectively. Conclusion: Symptoms suggestive of ET dysfunction are frequent in CRS, and for most patients the symptoms will decrease post-ESS to a level comparable with a non-CRS population. Patients' whose ET symptoms do not respond to ESS may represent a target population for emerging therapeutic options for ET dysfunction.