Eustachian Tube Dysfunction and Disease Severity in Patients with Chronic Rhinosinusitis in Rawalpindi, Pakistan

Abstract

Background: Chronic rhinosinusitis (CRS) is frequently associated with Eustachian tube dysfunction (ETD), exacerbating symptoms such as ear fullness, pressure, and pain. This study examines ETD prevalence in CRS patients undergoing functional endoscopic sinus surgery (FESS) in Rawalpindi, Pakistan—a high-pollution region—and evaluates the impact of FESS on both ETD and CRS symptoms.

Methods: A prospective cohort of 76 adult CRS patients was recruited at a tertiary care center. All participants completed the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and the 22-item Sino-Nasal Outcome Test (SNOT-22) preoperatively and 3 to 6 months postoperatively. Pearson and Spearman's correlations assessed the relationship between ETDQ-7 and SNOT-22 scores. Statistical significance was determined using paired t-tests.

Results: Preoperatively, 47.6% of patients scored ≥14.5 on ETDQ-7, indicating clinically significant ETD. Postoperative assessments showed significant reductions in both ETDQ-7 (mean preoperative 2.13 to postoperative 1.07, p < 0.05) and SNOT-22 scores (mean preoperative 48.0 to postoperative 24.0, p < 0.05). Correlation analysis revealed a strong association between ETDQ-7 scores and SNOT-22 ear/facial subdomain (Spearman r = 0.68, p < 0.0001), underscoring the impact of sinonasal inflammation on ETD.

Conclusion: ETD symptoms are prevalent in CRS patients and substantially improve after FESS, supporting the procedure’s role in managing both sinonasal and otologic symptoms. Effective ETD treatment in CRS patients, especially in high-pollution settings, can reduce symptom burden and enhance quality of life. Future studies should explore additional therapies for patients with persistent ETD post-FESS.