Friday, May 30, 2008

Eustachian tube dysfunction due to a deviated septum?

Q:

Hi there,

I'm afraid I have a question for you which doesn't involve ear wax! Can a
deviated septum cause eustachian dysfunction?

A:

Interesting question. I had never thought about it. My knee-jerk reaction
is to say 'no,' because I can't immediately think of any mechanism
whereby septal deviation could cause ETD. But the more I think about it,
the more I can devise scenarios and think of things I can't completely
account for. So I would have to say 'maybe.'

The neat thing about this question is that it's empirically testable by
correlating rhinomanometry data (which measures nasal air flow) with
tympanometry data (which measures middle ear pressures -- a direct
measure of Eustachian tube function). Do this before and after
septoplasty and see if the improved airway results in an improved ET
function.

I just searched PubMed and found a relevant article here
and here. The first study found worsening of ET function soon after septoplasty,
with some improvement much later, but many patients showed no change in
ET function. The second study had a very brief abstract (and the main
paper is in French), so there's no telling what they demonstrated.

I would tend to agree with the conclusion suggested in the abstract of
that first paper: "We suggest that it [nasal surgery] may be useful in
cases with severe nasal pathology or chronic infection of the nose or
the nasopharynx, if this is accompanied by poor tubal function." In
other words, if the ENT doc feels the septal deviation is contributing
to sinus infection (for example), which in turn is contributing to ETD,
then septal surgery is indicated. Otherwise, don't bother.

Hope this helps!

D.

66 Comments:

At 1:30 AM, Anonymous Bram said...

Thanks a bunch, this does help :)

 
At 8:22 PM, Anonymous kay said...

hi i have just a few days ago on wednesday had a tonsillectomy done and it is saturday i have alot of pain and also it is like i have an earache as well
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At 2:28 PM, Anonymous Jessika said...

Hi,

I stumbled across your blog through enlarged adenoids. But I feel like I am a different case. I am a woman in her early 20s, and I've never been able to breathe out of my nose. I have always been a so-called "mouth breather", and when I blow my nose it sounds like a loud trumpet. Seriously, I wake children with this thing. I have also never really been able to smell anything but extremely strong smells. I went to an ENT to have this all checked out, when I was about 19, and he said my blockage level is around a 9.5(?), on a scale of 10. I also get full blockage in my ears once a month from wax build-up, and have ringing sensation every once in a while. Is this related to my adenoids size? If so, would that allow enough "medical reason" to allow insurance to likely cover the procedure? I have stopped going to my ENT because my insurance called it a "cosmetic surgery".

 
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Fortunately my ear is not affected. Only problem is my itchy throat. Pls advice!

 
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