Middle Ear Function in Sinonasal Polyposis: A Case-Control Study

Abstract

Objectives:

Determine the effect of sinonasal polyposis on middle ear (ME) and Eustachian tube (ET) function.

Methods:

In a case-control survey, 90 cases in 3 groups including 42 advanced stage sinonasal polyposis patients, 24 patients with chief complaint of nasal obstruction in the absence of polyposis, and 24 healthy cases (not suffering from nasal obstruction or allergic rhinitis) were studied. Subjective ear- and nose-related complaints, tympanic membrane condition and movement during the Valsalva and Toynbee maneuvers, type of nasal secretions, polyposis staging both clinically (Lund Kennedy) and by imaging (Lund McKay), audiometric evaluation, and ET function tests were recorded.

Results:

Subjective hearing loss (P = .017), impaired TM movement during Toynbee maneuver (P = .027), Type B tympanogram (P = 0.025) showed significant difference in the polyposis group in comparison with the other 2. Furthermore, allergic rhinitis and nasal mucopurulent secretion were seen significantly more commonly among polyposis patients compared with other groups (P = .026, P = .000, respectively). TM movement during Toynbee maneuver (P = .004), type B tympanogram (P = .030), and Toynbee test (P = .004) showed a significant difference between patients who had purulent secretion compared with those without.

Conclusions:

It seems that sinonasal polyposis may change middle ear function to some extent, but the changes are related to the inflammation (allergic or infectious) associated with polyposis, rather than the nasal airway obstruction per se.