Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
Interplay Between Rhinosinusitis and Eustachian Tube Dysfunction in Patients Undergoing Functional Endoscopic Sinus Surgery.
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Wang Jing-Jie, Weng Chien-Hsiang, Yao Yi-Ting, Jiang Rong-San
Аннотация
OBJECTIVES: To evaluate the association between chronic rhinosinusitis (CRS) and Eustachian tube dysfunction (ETD) using subjective and objective measures, and the relationship between disease laterality and Eustachian tube function (ETF).
STUDY DESIGN: Prospective cohort study.
SETTING: Single tertiary medical institution.
METHODS: Eighty-five CRS patients who were candidates for FESS underwent comprehensive evaluation. Subjective assessments utilized the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) and Sino-Nasal Outcome Test-22 (SNOT-22). Objective evaluations comprised a 9-step inflation-deflation tympanometric test scored by maximal peak pressure difference (MPD), nasal endoscopy using the modified Lund-Kennedy (MLK) system, sinus CT scored via the Lund-Mackay (LM) system, and acoustic rhinometry measuring the second minimal cross-sectional area (MCA2). Patients were stratified into fair (<14) and poor (≥14) ETF groups based on ETDQ-7 scores. Correlations were analyzed using Pearson coefficients, receiver operating characteristic (ROC) curves, and Bland-Altman plots, with additional assessment of CRS lateralization effects.
RESULTS: Poor ETF (ETDQ-7 ≥ 14) occurred in 36.5% of patients and was associated with higher SNOT-22 (median 48.0 vs 31.5, P < .001). ETDQ-7 correlated moderately with SNOT-22 total (r = 0.65). No significant differences in MPD, MLK, LM, or MCA2 were found between fair and poor ET function groups. ROC analysis identified optimal cut-offs of ETDQ-7 > 15 (AUC 0.761) and SNOT-22 > 45 (AUC 0.802). Laterality analysis showed no significant side-specific associations.
CONCLUSION: In CRS, sinonasal symptom burden shows only a moderate association with patient-reported ETD. Higher ETDQ-7 scores often parallel greater SNOT-22 severity, suggesting that PROMs may help identify patients in whom ETD symptoms are partly influenced by CRS.
STUDY DESIGN: Prospective cohort study.
SETTING: Single tertiary medical institution.
METHODS: Eighty-five CRS patients who were candidates for FESS underwent comprehensive evaluation. Subjective assessments utilized the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) and Sino-Nasal Outcome Test-22 (SNOT-22). Objective evaluations comprised a 9-step inflation-deflation tympanometric test scored by maximal peak pressure difference (MPD), nasal endoscopy using the modified Lund-Kennedy (MLK) system, sinus CT scored via the Lund-Mackay (LM) system, and acoustic rhinometry measuring the second minimal cross-sectional area (MCA2). Patients were stratified into fair (<14) and poor (≥14) ETF groups based on ETDQ-7 scores. Correlations were analyzed using Pearson coefficients, receiver operating characteristic (ROC) curves, and Bland-Altman plots, with additional assessment of CRS lateralization effects.
RESULTS: Poor ETF (ETDQ-7 ≥ 14) occurred in 36.5% of patients and was associated with higher SNOT-22 (median 48.0 vs 31.5, P < .001). ETDQ-7 correlated moderately with SNOT-22 total (r = 0.65). No significant differences in MPD, MLK, LM, or MCA2 were found between fair and poor ET function groups. ROC analysis identified optimal cut-offs of ETDQ-7 > 15 (AUC 0.761) and SNOT-22 > 45 (AUC 0.802). Laterality analysis showed no significant side-specific associations.
CONCLUSION: In CRS, sinonasal symptom burden shows only a moderate association with patient-reported ETD. Higher ETDQ-7 scores often parallel greater SNOT-22 severity, suggesting that PROMs may help identify patients in whom ETD symptoms are partly influenced by CRS.