Impacto de la rinosinusitis crónica con pólipos nasales en la disfunción de la trompa de Eustaquio

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 function.

Material and methods

A prospective follow-up with all cases of chronic rhinosinusitis with nasal polyps 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 and the incidence of middle ear pathology. Polypoid involvement and tubal dysfunction were studied using several scores: Lildholdt's scale, Lund-Mackay nasal polyp grading, Lund-Kennedy endoscopic scoring system, SNOT-22 and Eustachian Tube Dysfunction Questionnaire-7 score.

Results

Information was collected from 155 patients, with an incidence of 15.1 cases/100,000 inhabitants. A percentage of 70.9 showed a type 2 inflammation profile. This group showed a higher average of cases with acute otitis media and effusion (18.1 vs. 4.4%; p < 0.001), 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 < 0.01) than the group without an eosinophilic profile or elevated IgE. The Eustachian Tube Dysfunction Questionnaire-7 score correlated well with the SNOT-22 and Lund-Kennedy scales.

Conclusions

Regression analysis revealed that a type 2 inflammation profile might play a more important role in tubal patency than nasal obstruction. Polyposis may alter Eustachian tube function, but more likely due to its inflammatory-allergic etiopathogenesis than to its obstructive nature.