ORIGINAL RESEARCH
The Effects of Smoking on Eustachian Tube Function and Surgical Outcomes in Patients with Chronic Otitis Media
Sigaranın Kronik Otitis Media Hastalarında Östaki Tüpü Fonksiyonu ve Cerrahi Sonuçlar Üzerindeki Etkileri
Received Date : 21 May 2023
Accepted Date : 19 Jul 2023
Available Online : 06 Sep 2023
Şamil ŞAHİNa, Betül AKTAŞb, Burak ERKMENc, Yaşar Kemal DUYMAZd,
Ahmet Mahmut TEKİNe, Serap ÖNDERd, Burak KARABULUTa
aPrivate Physician, İstanbul, Türkiye
bDepartment of Otolaryngology, University of Health Sciences Şanlıurfa Training and Research Hospital, Şanlıurfa, Türkiye
cDepartment of Otolaryngology, University of Health Sciences Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Türkiye
dDepartment of Otolaryngology, University of Health Sciences Ümraniye Training and Research Hospital, İstanbul, Türkiye
ePrivate Physician, Nordrhein-Westfalen, Germany
Doi: 10.24179/kbbbbc.2023-98046 - Makale Dili: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2023;31(4):194-9.
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Effect of smoking on the Eustachian tube
(ET) function is unknown specifically in humans. The literature about
smoking as a prognostic factor in chronic otitis media (COM) surgery
is showing discrepancies. We evaluated the ET function by the saccharin
test. Test results compared between smokers and nonsmokers.
Surgical outcomes assessed between groups due to smoking status and
ET function. Material and Methods: A prospective case series was
conducted at a tertiary referral center on 83 COM patients undergoing
endoscopic Type 1 cartilage tympanoplasty. Patients were classified
based on saccharin test results into 3 groups; normal function, partial
dysfunction, and gross dysfunction. Smoking status was used to evaluate
ET function, and perforations were categorized as anterior, central,
or posterior. Surgical success rates were compared between smokers
and non-smokers. Results: The saccharin test showed no significant
difference in ET function between smokers and non-smokers. Patients
with gross dysfunction had more anteriorly localized perforations. Surgical
success rates did not significantly differ between smokers and
non-smokers, and ET function did not affect outcomes. Conclusion:
Anteriorly localized perforations in tympanic membrane should bring
to mind the ET dysfunction. Tragal cartilage is a reliable graft material
for patients with smoking history and ET dysfunction.
Keywords: Smoking; Eustachian tube function; chronic otitis media; endoscopic tympanoplasty; tragal cartilage
ÖZET
Amaç: Bu çalışmanın amacı, sigara içmenin Östaki tüpü fonksiyonu
ve timpanoplasti başarısı üzerindeki etkisini değerlendirmektir.
Gereç ve Yöntemler: Üçüncü basamak bir merkezde, endoskopik Tip
1 kıkırdak timpanoplasti uygulanan 83 kronik otit hastası üzerinde yapılan
prospektif bir çalışmadır. Hastalar sakkarin testi sonuçlarına göre
3 gruba ayrıldı; normal işlev, kısmi işlev bozukluğu ve ileri işlev bozukluğu.
Östaki tüpü fonksiyonunu değerlendirmek için sigara içme
durumu kullanıldı ve perforasyonlar anterior, santral veya posterior olarak
kategorize edildi. Sigara içenler ve içmeyenler arasında cerrahi başarı
oranları karşılaştırıldı. Bulgular: Sakkarin testi, sigara içenler ve
içmeyenler arasında östaki tüpü fonksiyonunda anlamlı bir fark göstermedi.
İleri derecede disfonksiyonu olan hastalarda perforasyonlar
daha anterior yerleşimliydi. Cerrahi başarı oranları, sigara içenler ve
içmeyenler arasında anlamlı bir farklılık göstermedi ve östaki tüpü
fonksiyonu sonuçlarını etkilemedi. Sonuç: Timpanik membranda anterior
yerleşimli perforasyonlar östaki borusu disfonksiyonunu akla getirmelidir.
Tragal kartilaj, sigara öyküsü ve östaki tüpü disfonksiyonu
olan hastalar için güvenilir bir greft materyalidir.
Anahtar Kelimeler: Sigara içmek; Östaki tüpü fonksiyonu; kronik otitis media; endoskopik timpanoplasti; tragal kartilaj
KAYNAKLAR
- Bluestone CD, Paradise JL, Beery QC. Physiology of the eustachian tube in the pathogenesis and management of middle ear effusions. Laryngoscope. 1972;82(9):1654-70. [Crossref] [PubMed]
- Bylander-Groth A, Stenström C. Eustachian tube function and otitis media in children. Ear Nose Throat J. 1998;77(9):762-4, 766, 768-9. [Crossref] [PubMed]
- Bluestone CD, Swarts JD. Human evolutionary history: consequences for the pathogenesis of otitis media. Otolaryngol Head Neck Surg. 2010;143(6):739-44. [Crossref] [PubMed] [PMC]
- Sade J. Pathology and pathogenesis of serous otitis media. Arch Otolaryngol. 1966;84(3):297-305. [Crossref] [PubMed]
- Sadé J, Ar A. Middle ear and auditory tube: middle ear clearance, gas exchange, and pressure regulation. Otolaryngol Head Neck Surg. 1997;116(4):499-524. [Crossref] [PubMed]
- Ikehata M, Ohta S, Mishiro Y, Katsura H, Miuchi S, Tsuzuki K, et al. Usefulness of the saccharin test for assessment of eustachian tube function in patients with chronic otitis media with perforation. Otol Neurotol. 2017;38(1):60-5. [Crossref] [PubMed]
- Lee IW, Goh EK, Roh HJ, Lee CH, Chung BJ, Chon KM. Histologic changes in the eustachian tube mucosa of rats after short-term exposure to cigarette smoke. Otol Neurotol. 2006;27(3):433-40. [Crossref] [PubMed]
- Salviz M, Bayram O, Bayram AA, Balikci HH, Chatzi T, Paltura C, et al. Prognostic factors in type I tympanoplasty. Auris Nasus Larynx. 2015;42(1):20-3. [Crossref] [PubMed]
- Becvarovski Z, Kartush JM. Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI). Laryngoscope. 2001;111(10):1806-11. [Crossref] [PubMed]
- Prasad KC, Hegde MC, Prasad SC, Meyappan H. Assessment of eustachian tube function in tympanoplasty. Otolaryngol Head Neck Surg. 2009;140(6):889-93. [Crossref] [PubMed]
- Uguz MZ, Onal K, Kazikdas KC, Onal A. The influence of smoking on success of tympanoplasty measured by serum cotinine analysis. Eur Arch Otorhinolaryngol. 2008;265(5):513-6. [Crossref] [PubMed]
- Kyrodimos E, Stamatiou GA, Margaritis E, Kikidis D, Sismanis A. Cartilage tympanoplasty: a reliable technique for smokers. Eur Arch Otorhinolaryngol. 2014;271(2):255-60. [Crossref] [PubMed]
- Coelho DH, Peng A, Thompson M, Sismanis A. Cartilage tympanoplasty in smokers. Ann Otol Rhinol Laryngol. 2012;121(10):657-63. [Crossref] [PubMed]