Combined Endoscopic Sinus Surgery and Eustachian Tube Balloon dilatation improves Eustachian Tube Functions in patients had Chronic rhinosinusitis with nasal polyposis and Eustachian tube dysfunction

Abstract

Background: Chronic rhinosinusitis [CRS] is a distressing disease that affects patients' mental and physical health. Eustachian tube dysfunction [ETD] affects approximately 1% of the adult population, especially patients with rhinosinus diseases.Transnasal Balloon Eustachian tuboplasty [BET] is a safe intervention for adult patients with chronic ETD. Aim of the work:To evaluate the impact of combined Function endoscopic sinus surgery [FESS] for CRS and BET on ETD manifestations compared to FESS only.Patients and Methods: 45 patients were randomly allocated into Group C underwent FESS, and Group-I underwent FESS and BET. ETD was evaluated using the 7-item Eustachian Tube Dysfunction Questionnaire [ETDQ-7] score, Otoscopy, Valsalva maneuver, and tympanometry. BET was performed using the XprESS ENT Dilation System with balloon inflation to 12 atmospheres for 2-min. Study outcomes were determined after 6-wk.Results: At 6-wk, the frequency of normal TM position and positive Valsalva's maneuver was significantly higher, and ETDQ-7 scores were significantly improved in all patients, while the frequency of tympanogram type-A was significantly and non-significantly higher in groups I and C, respectively. ROC curve and Regression analyses defined the application of FESS with BET as the significant predictor for normalization of tympanogram to type-A. Conclusion:Coupling Balloon Eustachian tuboplasty with Function endoscopic sinus surgery provided outcome more superior to Function endoscopic sinus surgery alone. Balloon Eustachian tuboplasty in experienced hands can be performed with a 100% technical success rate