Study the Effect of Nasal Obstruction Surgery (Septoplasty) on Eustachian Tube Function and Middle Ear Pressure

Deviation of the nasal septum is a common cause of unilateral or bilateral nasal airway obstruction and may follow nasal and midface trauma. Patient complaints of airway obstruction that are consistent with intranasal physical findings often lead to septoplasty and turbinate surgery. Severe nasal septal deviation leads to complete nasal obstruction and disturbs air passage from nostrils، however the effect of septal deviation and nasal obstruction surgery (septoplasty) on Eustachian tube function and middle ear pressure is controversial and isn’t clear. Whereas many of surgeons do not believe the considerable effect of septoplasty on Eustachian tube function and middle ear pressure، so they do not recommend this procedure before middle ear surgery. On the other hand، some have an idea that septoplasty has significant effect on middle ear pressure suggesting this procedure before ear surgery like tympanoplasty. This prospective analytical-descriptive study was conducted on seventy patients from 18 to 65 years of age who underwent septoplasty due to severe septal deviation leading to nasal obstruction in Beesat Hospital during one year (2012-2013). Middle ear pressure and Eustachian tube function on the septal deviated side and contralateral side before and after septoplasty (3 to 6 months later) were measured through tympanometry and Eustachian tube function test (Toynbee test). The comparison between pre- and postoperative ETF tests and middle ear pressures was assessed using Paired –T test and p-value of less than 0. 05 was considered as statistically significant. This study revealed that comparison between mean values of pressure in the deviated and contralateral side has no significant statistical difference before and after septoplasty. Also comparison between Eustachian function in the deviated side and contralateral side showed no significant difference before and after septoplasty. The septoplasty didn’t have considerable effect on Eustachian tube function and middle ear pressure three to six months after surgery، and on the basis of pre- and post operative measurements it was stated that surgical correction of a nasal septal deviation before ear surgery such as tympanoplasty is not justified.