Effect of anterior nasal packing on middle ear pressure and hearing threshold

ABSTRACT

To evaluate the effect of anterior nasal packing on middle ear pressure and hearing threshold. Prospective study conducted between June and December 2007. Department of Otolaryngology, Al-Adan Hospital, Ministry of Health, Kuwait. Twenty patients of either sex in the age group 18 - 45 years admitted for septoplasty. Pure Tone Audiometry [PTA] and impedance audiometry [IA] were done in all patients preoperatively, 48 hours after surgery with nasal packs in position and seven days after removal of packs. PTA and IA before and after nasal packing. Normal middle ear pressure was observed preoperatively in most of the ears. Forty eight hours after septal surgery with nasal packs in position, 14 ears had abnormal negative middle ear pressure of 100 to 300 mm H2O. Seven days after pack removal, there was marked improvement in middle ear pressure. Hearing threshold remained normal before and after surgery. Nasal packing following septal surgery is a frequent cause of short-term eustachian tube dysfunction but rarely severe enough to cause symptoms of middle ear effusion. Tubal dysfunction is most likely due to peritubal inflammationorstasisofperituballymphaticsand reduced swallowing in the post operative period due to pain. Changes in middle ear pressure following nasal packing associated with most nasal surgeries were transient and not severe. Pure Tone Audiometry [PTA]