Assessment of nasal functions and their relationship with cholesteatoma formation in patients with unilateral chronic otitis media

Abstract

ObjectivesTo evaluate the nasal functions of patients with unilateral chronic otitis media using rhinomanometry, comparing chronic otitis media sides with healthy sides, chronic otitis media patients with cholesteatoma and without cholesteatoma, and patients with healthy individuals.MethodsThis prospective study included 102 patients with unilateral chronic otitis media (48 with and 54 without cholesteatoma). The control group comprised 40 individuals without any ear or nasal pathologies. All patients underwent active anterior rhinomanometry to measure nasal airway resistance and a saccharin test to measure mucociliary transport times.ResultsThere were no significant differences in nasal airway resistance and mucociliary transport time between the chronic otitis media sides and unaffected sides in the 102 patients (p = 0.72 and p = 0.28, respectively), between the non-suppurative chronic otitis media patients (without cholesteatoma) and chronic otitis media with cholesteatoma patients (p > 0.05), or between the study and control groups (p > 0.05).ConclusionThe present study, with a larger sample size compared to previously published literature, supports the conclusion that unilateral nasal obstruction is unlikely to lead to chronic otitis media on the same side. The results also suggest that nasal functions do not contribute to the development of cholesteatoma.

Linking Chronic Otitis Media and Nasal Obstruction: A CFD Approach

“…Watson et al 6 determined by anterior active rhinomanometry that in a sample of 15 patients with COM the nasal resistance on the side of the affected ear was significantly greater than in controls. But, using the same technique, Arsla et al 8 did not find significant differences in nasal airway resistance between the COM sides and unaffected sides between 102 patients with unilateral COM and 40 individuals without any ear or nasal pathologies controls. And Toros et al 10 did not observe correlation between the ear with COM and the side of nasal obstruction by acoustic rhinometric in a sample of 55 patient with COM.…”

“…However, the relationship between the nose conditions and COM is controversial. While some authors have found a significant correlation between the incidence of nasal pathology and COM, 4–7 others do not find such a correlation 8–11 . Regardless of the role of alterations of the nose and/or nasopharynx on the middle ear, the intimate knowledge of this relationship would be of great interest for the treatment of patients with COM and concomitant nasal and/or nasopharyngeal alterations, a very common situation in the clinical practice.…”

“…While some authors have found a significant correlation between the incidence of nasal pathology and COM, [4][5][6][7] others do not find such a correlation. [8][9][10][11] Regardless of the role of alterations of the nose and/or nasopharynx on the middle ear, the intimate knowledge of this relationship would be of great interest for the treatment of patients with COM and concomitant nasal and/or nasopharyngeal alterations, a very common situation in the clinical practice. However, despite some study that sheds some light on this aspect, 11 no specific guidelines have been defined for the management of patients with COM and associated nasal and/or nasopharyngeal alterations.…”