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The prevalence of Eustachian tube dysfunction symptoms in patients with chronic rhinosinusitis
Authors:Navarat Tangbumrungtham MD  Vishal S. Patel BS  Andrew Thamboo MD  MHSc  Zara M. Patel MD  Jayakar V. Nayak MD  PhD  Yifei Ma MS  Garret Choby MD  Peter H. Hwang MD
Affiliation:1. Department of Otolaryngology–Head and Neck Surgery, Stanford University, Stanford, CA;2. Department of Otorhinolaryngology, Ramathibodi Hospital, Bangkok, Thailand;3. Department of Otorhinolaryngology, University of British Columbia, Vancouver, Canada;4. Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN
Abstract:

Background

While Eustachian tube dysfunction (ETD) is a known comorbidity of chronic rhinosinusitis (CRS), the prevalence of ETD symptoms in the CRS population is poorly understood. We sought to determine the cross‐sectional prevalence of ETD in patients with CRS using the validated Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) and to correlate ETDQ‐7 scores with 22‐item Sino‐Nasal Outcome Test (SNOT‐22) scores, endoscopy scores, and computed tomography (CT) scores.

Methods

A total of 101 patients with confirmed CRS completed the ETDQ‐7 and SNOT‐22 at their initial visit to our rhinology clinic. Lund‐Mackay CT and Lund‐Kennedy endoscopy scores were also obtained. Spearman's correlation coefficient (ρ) was calculated.

Results

Among the 101 patients, 49 patients (48.5%) had an ETDQ‐7 score of ≥14.5, signifying clinically significant ETD. The mean ± standard deviation (SD) ETDQ‐7 score of the entire cohort was 17.8 ± 10.1. There was a moderately strong correlation between ETDQ‐7 and the SNOT‐22 ear subdomain (ρ = 0.691, p < 0.001). The correlation coefficient between ETDQ‐7 and total SNOT‐22 scores was ρ = 0.491 (p < 0.001), indicating moderate correlation. ETDQ‐7 scores were poorly correlated to objective measures of sinonasal disease, including Lund‐Mackay CT score (ρ = ?0.055, p = 0.594) and Lund‐Kennedy endoscopy score (ρ = ?0.099, p = 0.334).

Conclusion

Symptoms of ETD are highly prevalent among patients with CRS as documented by patient‐reported outcome measures. The correlation between ETDQ‐7 scores and SNOT‐22 ear subdomain scores is moderately strong, while the correlation between ETDQ‐7 scores and SNOT‐22 scores is moderate. ETD severity does not correlate with CT score or nasal endoscopy score.
Keywords:Eustachian tube dysfunction  chronic rhinosinusitis  otologic symptoms  ear fullness  ear pressure  sinusitis  ear disease
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