ABSTRACT
Objectives: There has been anecdotal evidence that otalgia and
ear fullness are associated with a deviated nasal septum (DNS). The goal
of this novel, pilot study is to evaluate if eustachian tube dysfunction
(ETD) is associated with a DNS and improved following septoplasty.
Design : Prospective comparative pilot study
Setting : Tertiary hospital at an academic institution
Participants : Twenty-five patients with septal deviations (16
with otalgia and 9 controls) underwent septoplasty with inferior
turbinate reduction between November 2016 and May 2018.
Main Outcome Measures: ETDQuestionnaire (ETDQ-7), Sino-nasal Outcome
Test (SNOT-22), and Nasal Obstruction Symptom Evaluation (NOSE) assessed
quality of life pre and post operation.
Results : Mean SNOT-22 scores decreased significantly for both
groups (p< 0.05). The results of the ETDQ-7 showed aural
symptoms significantly decreased for case patients at 6 weeks (-17.4,
p=0.016) which continued through week 12. Symptoms of ear fullness and
pain were significantly reduced in the case group (p<0.05).
With both groups experienced a reduction in all questionnaires,
decreased SNOT-22 scores correlated with ETDQ-7 (p=0.0012) and NOSE
(p<0.036) improvements while the control group did not see
test correlations.
Conclusions : Overall, our study demonstrated otalgia or ear
fullness could be associated with a DNS. The data suggests significant
correlations between all three questionnaires in evaluating patients
with nasal obstruction and aural symptoms, and that they are reasonable
tools in evaluating ETD outcomes concerning septoplasty. Thus, we
propose that nasal septum deviation be evaluated and included in any
algorithm for the diagnosis and management of patients with ETD.
Keywords: Otalgia, septum deviation, eustachian tube
dysfunction, ear pain, quality of life, SNOT, ETDQ, septoplasty