Harish Swamy Dharmagadda1 , Sunil Kumar Rathod2
BACKGROUND Allergic rhinitis also causes dysfunction of Eustachian tube as it can lead to frequent episodes of congestion and production of mucus. We wanted to study the need for ventilating tube insertion in allergic rhinitis patients with dysfunctional Eustachian tube. METHODS We studied 200 allergic rhinitis patients and only 30 patients have presented with symptoms related to dysfunction of Eustachian tube which were elicited with the help of history, pure tone audiometry and tympanometry and 20 patients with persistent dysfunction of Eustachian tube even after 3 weeks of conservative treatment with combination of levocetirizine, montelukast and nasal steroid spray for 3 weeks, antibiotics (amoxicillin + clavulanate or cefpodoxime) for 1 week, short term nasal decongestants for 1 week have been chosen for the study while the rest of the 10 patients did not meet the inclusion criteria. These 20 patients underwent myringotomy with tympanostomy tube insertion and postoperatively we have continued antibiotic therapy for another 1 week along with intranasal steroidal spray and levocetirizine & montelukast for 2 weeks. RESULTS Patients who underwent myringotomy and tympanostomy tube placement have shown good results. The 20 patients under study have been evaluated again later in 6 months which included history, impedance audiometry, and pure tone audiometry. During the follow up, all the patients under study had undergone thorough physical examination and we noticed that in 2 patients grommet had fallen off around 3 - 4 months while 3 other patients had grommet intact on 6th month follow up as well. Every patient under the study was subjected to audiological examinations. For the ones with intact grommet, they were assessed based on the symptomatic relief and pure tone audiometry but not tympanometry. A definitive improvement has been noticed in 16 patients out of 20. The other 4 patients haven’t shown any clinical and audiological improvement. In the age group of 11 - 20 years 3 patients improved and 2 did not improve, in the 21 - 30 years age group 10 patients showed good improvement and in the 31 - 40 years age group 3 patients have shown improvement and 2 patients didn’t improve. Data analysis was done with the help of statistical software SPSS version 25, p – value <0.05 was considered as significant. CONCLUSIONS Allergic rhinitis patients who are presenting with persistent dysfunction of the Eustachian tube require myringotomy and tympanostomy tube placement along with medical treatment.
