The Relationship between Deviated Nasal Septum and Middle Ear Pressure

Abstract

The Nose/Ear Distress Syndrome is defined as the combination of nasal septal deformity and eustachian dysfunction in the absence of any other pathology (McNicoll and Scanlan,1979). Until now, there have been few literatures strongly mentioned about it in the scientific role, and this relationship has not been studied in Thai people. The relationship between deviated nasal septum (DNS) and middle ear pressure (MEP) was then studied with the audiometry, tympanometry, rhinomanometry, and acoustic rhinometry. A total of 80 patients with DNS was recruited and divided into 2 groups; The allergic rhinitis group (n = 40) and the control group (n = 40). Each group could be further divided into 2 subcategories: (a) DNS to Right (nasal airflow: right side< left side) (n = 44) (b) DNS to left (nasal airflow: left side< right side) (n = 36). The mean of patient's age was 33.5 years (range: 11-56 years). The mean of minimal cross-sectional area in patients with DNS and its length from anterior nostril (after decongestion) were 0.7 cm2; 1.6 cm on the left side and 0.7 cm2;1.4 cm on the right side, respectively. The mean of MEP (n = 80) was - 17.3 daPa (S.D.=13.4) on the left side and - 18.7 daPa (S.D.=14.3) on the right side. In each subcategory of both groups, there were no significant differences in MEP between both sides (p > 0.05) although there were significant differences in airflow and resistance (p < 0.05). Furthermore, the difference of nasal airflow or nasal resistance between both sides did not significantly correlate with the difference of MEP (p > 0.05). The number of patients who had auditory symptom was 9 (22.5%) in the control group and 4 (10%) in the allergic rhinitis group. There were no significant differences in incidence of auditory symptom between both groups (p > 0.05). Between the patients who had auditory symptom (n = 13) and had no auditory symptom (n = 67), the difference of nasal airflow, nasal resistance, and MEP between both sides did not differ significantly (p > 0.05). In summary, we found no relationship between DNS and MEP in this study.