Table 5.

The summary of studies in investigation of Eustachian tube function following ESS

Study	No.	Study design	Follow-up period	Nasal polyps	Survey tools	Results
Stoikes and Dutton6	168	Retrospective	Mean 14 mo	8.9%	Self-designed questionnaire	Significant improvement of ear fullness/congestion, ear cracking/popping, dizziness, and ear pain after sinus surgery.
Teo et al8	395	Prospective	Mean 13.9 mo	37.7%	SNOT-22 Otologic domain	Significant improvement of otologic symptom scores, included ear fullness, dizziness and ear pain.
Maniakas et al9	131	Prospective	Mean 3.8 mo	No report	SNOT-22 Otologic domain	A total of 78.8% patients reported an improvement of ear fullness score, 73.3% patients reported an improvement of ear painscore.
Chang et al16	302	Retrospective	6 mo	41.7%	ETDQ-7	On multivariate analysis, ETD improvement was associated with higher preoperative ETDQ-7 score, higher preoperative SNOT-22 score, higher preoperative SNOT-22 ear subscore, posterior ethmoidectomy, and postoperative corticosteroid spray use.
Bowles et al17	57	Prospective	9 mo	40.4%	ETDQ-7 Tympanogram	Mean ETDQ-7 scores were significantly lower following ESS. Type A tympanograms increased form 76.6% preoperatively to 96% postoperatively.
Higgins et al22	60	Prospective	2 mo	30.0%	ETDQ-7	ESS was associated with ETDQ-7 improvement. Nasal polyposis was associated with a higher probability of ETDQ-7 normalization. Factors associated with failure of ETDQ-7 normalization included TMJD and high preoperative ETDQ-7.
Choi et al23	60a	Prospective	3 mo	73.3%	ETDQ-7 Valsalva test Inflation test Deflation test	Compared with the group without sinusitis, the ESS group showed significant improvement of E-tube function after surgery in the ETDQ-7, right Valsalva test, right deflation test, and left deflation test.
Chen et al24	70	Prospective	2-3 mo	72.9%	ETDQ-7 Tympanogram	Failure of normalization of ETDQ-7 postoperatively was associated with allergic rhinitis and higher preoperative SNOT-22 score in multivariate analysis. Preoperative type B tympanogram changed to type A or type C in 58.3% postoperatively.
Chen et al (this study)	92	Prospective	12 mo	42.4%	ETDQ-7	Patients who received revision surgery had higher ETDQ-7 scores during the follow-up period. The multivariate analysis showed revision surgery was an independent predictor of persistent otologic symptom 1-y postoperatively.

ESS = Endoscopic sinus surgery; ETDQ-7 = 7-Item Eustachian Tube Dysfunction Questionnaire; SNOT-22 = 22-Item Sino-Nasal Outcome Test; TMJD = temporomandibular joint dysfunction.

^aESS (n = 30) vs other nasal surgeries (n = 30).