Impact of Sinonasal Disease on Eustachian Tube Dysfunction

Purpose of review Eustachian tube dysfunction (ETD) is a common disease caused by abnormal function of the Eustachian tube. Sinonasal diseases, such as allergic rhinitis (AR) and chronic rhinosinusitis (CRS), are known to induce ETD through mucosal edema and Eustachian tube obstruction. As a result, ETD is often treated with medical therapies used to manage AR and CRS. This review serves to summarize the pathologic link between sinonasal diseases and ETD and the current state of evidence on the impact of treatments used for sinonasal diseases on ETD.Recent findings There is a high prevalence of ETD in patients with sinonasal disease, ranging from 15.5 to 89%, with a strong correlation in severity of sinonasal disease and ETD (Bernstein, Otolaryngol -Head Neck Surg. 1996;114:562-8; Hardy et al., Oto-laryngol -Head Neck Surg. 2001;125:339-45; Knight et al., Clin Otolaryngol Allied Sci. 1992;17:308-12; Juszczak and Loftus, Curr Allergy Asthma Rep. 2020;20; Lazo-S & aacute;enz et al., Otolaryngol -Head Neck Surg. 2005;132:626-9; Ma et al., Clin Transl Allergy. 2020;10:1-11; Yeo et al., Am J Otolaryngol -Head Neck Med Surg. 2007;28:148-52; Fire-man, J Allergy Clin Immunol. 1997;99:787-97). Traditional medical treatments used to treat sinonasal diseases, including topical steroids, antihistamines, and decongestants, have demonstrated limited success in normalizing tympanograms and improving ETDQ-7 scores. Endoscopic sinus surgery (ESS), however, has been demonstrated to be effective in reducing ETD symptoms in patients with CRS, with ETDQ-7 scores reduced postoperatively by a mean of 7.4.Summary ETD is driven by various etiologies, such as AR and CRS. Recognizing the cause behind patients' ETD is important in effectively managing their symptoms.