Impact of chronic rhinosinusitis with nasal polyps on Eustachian tube dysfunction.

Abstract

Introduction: Adequate nasal patency has been classically considered a crucial factor in middle ear ventilation. We valued the influence of nasosinusal polyposis on Eustachian tube (ET) function.

Material and methods: A prospective follow-up with all cases of chronic rhinosinusitis with nasal polyps (CRSwNP) assisted between January 2019 and October 2024 was carried out. Their endoscopic, radiological and clinical characteristics were noted, as well as the presence of a type 2 inflammation context (T2I) and the incidence of middle ear pathology. Polypoid involvement and tubal dysfunction were studied using several scores: Lidholdt's scale, Lund-McKay nasal polyp grading, Lund-Kennedy endoscopic scoring system, SNOT-22 and Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) score.

Results: Information was collected from 155 patients, with an incidence of 15,1 cases/100,000 inhabitants. 70,9% showed an T2I profile. This group showed a higher average of cases with acute otitis media and effusion (18,1% vs. 4,4%; P < .001), tympanometric alterations (12,7% vs. 4,4%; P < 0.01), conductive hearing loss (17,2%. vs 4,4%; P < 0.001) and needing for transtympanic drains (9,1% vs. 2,2%; P < .01) than the group without an eosinophilic profile or elevated IgE. The ETDQ-7 score correlated well with the SNOT-22 and Lund-Kennedy scales.

Conclusions: Regression analysis revealed that an T2I profile might play a more important role in tubal patency than nasal obstruction. Polyposis may alter ET function, but more likely due to its inflammatory-allergic aetiopathogenesis than to its obstructive nature.