Eustachian Tube Dysfunction and Hearing Abnormalities among Patients with Chronic Rhinosinusitis

Open Access

Abstract

Background: Eustachian tube dysfunction (ETD) may occur in patients with chronic rhinosinusitis (CRS) because persistent sinonasal inflammation can impair Eustachian tube ventilation and middle-ear pressure regulation. Hearing abnormalities may accompany this dysfunction, particularly when conductive mechanisms are involved. Aim of the study: To determine the occurrence of ETD and hearing abnormalities among patients with CRS and to characterize their associated clinical and audiological findings. Methods & Materials: This cross-sectional analytical study included 80 adults with CRS selected by purposive sampling. Participants underwent clinical and nasal endoscopic assessment, tympanometry, Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and pure-tone audiometry. ETD was defined using tympanometric findings and an ETDQ-7 score ≥2.1. Associations between clinical characteristics, ETD, and hearing abnormalities were analyzed using appropriate statistical tests, with p<0.05 considered statistically significant. Result: The mean age was 39.2±11.6 years, and 57.5% of participants were male. ETD was identified in 27 (33.75%) participants, including unilateral ETD in 16 (20.0%) and bilateral ETD in 11 (13.75%). Hearing abnormalities were present in 23 (28.75%), including conductive hearing loss in 14 (17.5%), sensorineural hearing loss in 6 (7.5%), and mixed hearing loss in 3 (3.75%). ETD was significantly associated with CRS duration, nasal polyps, bilateral CRS, and inferior turbinate hypertrophy (p=0.021, p=0.008, p=0.032, and p=0.046, respectively). Hearing abnormalities were significantly more frequent among participants with ETD than those without ETD (55.56% vs. 15.01%, p<0.001). Conductive hearing loss (44.44% vs. 3.77%), air-bone gap ≥10 dB (51.85% vs. 9.43%), and mean PTA (29.4±10.8 vs. 21.8±7.2 dB) were also significantly higher among participants with ETD (all p<0.001). Conclusion: ETD was common among patients with CRS and was significantly associated with longer disease duration and selected sinonasal findings. ETD was also strongly associated with hearing abnormalities, particularly conductive hearing loss and increased PTA thresholds. Routine assessment of Eustachian tube function and hearing may therefore be valuable in CRS patients with persistent, bilateral, or extensive sinonasal disease.