Study to Correlate Deviated Nasal Septum and Middle Ear Ventilation

Keshav Gupta, S M Faiz, Anuja Bhargava, Saurabh Srivastava, Rajeev Krishna Gupta, Abdul Khalid, Momina Siddiqui, Medhavi Sharma
Author(s)
1Senior Resident, Gupta Hospital, Jalandhar, Punjab, India. 2Professor, Department of Otorhinolarngology and Head & Neck Surgery, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. 3Professor & Head, Department of Otorhinolarngology and Head & Neck Surgery, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. 4Associate Professor, Department of Otorhinolarngology and Head & Neck Surgery, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. 5Senior Resident, Department of Otorhinolarngology and Head & Neck Surgery, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. 6Junior Resident, Department of Otorhinolarngology and Head & Neck Surgery, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India

Abstract

Background: Deviated Nasal Septum (DNS) is a common anatomical abnormality that may impair nasal airflow and alter nasopharyngeal dynamics. Because the Eustachian tube connects the middle ear to the nasopharynx, structural abnormalities of the nasal cavity may influence middle ear ventilation and contribute to Eustachian tube dysfunction (ETD). The aim is to study the correlation between Deviated Nasal Septum and middle ear. Material and Methods: This cross-sectional study was conducted over two years in the Department of Otorhinolaryngology, Era’s Lucknow Medical College and Hospital, Lucknow. A total of 120 patients aged ≥18 years with DNS were included. Patients with allergic rhinitis, chronic sinusitis, nasal polyposis, upper respiratory tract infection, prior nasal or ear surgeries, or sleep apnea were excluded. Assessment included NOSE score, ETDQ-7 score, diagnostic nasal endoscopy, CT scan of nose and paranasal sinuses, tympanometry, pure tone audiometry, and Eustachian tube function tests (Valsalva, Toynbee, Williams). Statistical analysis included chi-square test and Student’s t-test. Results: Majority of patients were aged 18–30 years (46.7%), with male predominance (53.3%). Congestion (75%) was the most common nasal symptom. Cracking/popping sounds (50%) were the most common ETD symptom. Type 1 DNS (20%) was most frequent. Type A tympanogram was seen in 65.8%, Type B in 24.2%, and Type C in 10%. ET dysfunction was present in 77.5% of patients. A significant association was found between laterality of DNS and side of ET dysfunction (χ²=16.727; p=0.001). NOSE and ETDQ-7 scores were significantly higher in patients with ET dysfunction (p=0.012 and p<0.001 respectively). Conclusion: Deviated nasal septum is associated with Eustachian tube dysfunction and altered middle ear ventilation. Severity of nasal obstruction correlates with ETD symptom scores.

Keywords: Deviated Nasal Septum (DNS), Middle Ear Ventilation, Eustachian Tube Dysfunction, Tympanometry, Nasal Obstruction, Middle Ear Pressure.

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