Surgical Correction of Nasal Obstruction and Its Effect on Eustachian Tube Dysfunction Symptoms.

Autor: Daum R; Dell Medical School, University of Texas at Austin, Austin, Texas, USA.; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., Grimm D; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., Castro Silva BR; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., Huang AE; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., Lee JY; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., Nayak JV; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., Patel ZM; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., Hwang PH; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA., Chang MT; Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2024 Mar; Vol. 170 (3), pp. 944-951. Date of Electronic Publication: 2023 Nov 30.
DOI: 10.1002/ohn.607
Abstrakt: Objectives: To investigate how eustachian tube dysfunction symptoms change following surgical treatment of nonsinusitis-related nasal obstruction.
Study Design: Retrospective chart review.
Setting: Single academic center.
Methods: We assessed patients who underwent septoplasty, turbinate reduction, or both for nasal obstruction. Chronic sinusitis patients were excluded. Eustachian tube dysfunction (ETD) symptoms were studied using the Eustachian Tube Dysfunction Questionnaire (ETDQ-7), collected preoperatively and postoperatively (1 week, 1 month, 3 months, 6 months postop). Patients with preoperative ETDQ-7 > 14.5 were considered to have clinically significant symptoms. Sinonasal outcomes test scores were also assessed. Pre- and postoperative ETDQ-7 scores were compared using t test. Multivariate linear regression analysis identified factors associated with ETDQ-7 change.
Results: We analyzed 259 patients. Preoperatively, 37.5% of patients with nasal obstruction had clinically significant ETD symptoms. These patients exhibited significant improvement in ETDQ-7 at all postoperative timepoints from 23.3 ± 7.6 at baseline to 19.1 ± 9.1 at 1 week, 16.5 ± 8.0 at 1 month, 16.2 ± 7.8 at 3 months, and 16.7 ± 10.4 at 6 months (all P < .01). In patients without baseline ETD symptoms, (baseline ETDQ-7: 9.1 ± 2.3) ETDQ-7 scores did not change significantly at postoperative timepoints, except for an acute worsening at 1 week postoperatively (10.7 ± 5.1, P < .001). Regression analysis showed that higher preoperative ETDQ-7 score (β = -0.84, 95% confidence interval [CI]: -1.10 to -0.59) and postoperative antihistamine spray usage (β = -8.70, 95% CI: -14.20 to -3.20) were associated with ETDQ-7 improvement, while comorbid GERD (β = 7.50, 95% CI: 3.42-11.58) and asthma (β = 5.62, 95% CI: 0.80-10.45) were negatively associated with improvement.
Conclusion: Surgical correction of nasal obstruction may improve ETD symptoms.
(© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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