The Effects of Obesity on the Eustachian Tube Function in Saudi Adults (A Cross-Sectional Study)

Eustachian tube dysfunction is estimated to occur as a chronic condition in approximately 4% of adults worldwide. Several studies have suggested that obesity (defined by WHO as a body mass index of 30 or more) [1] can predispose to Eustachian tube dysfunction because fatty deposits may accumulate around the Eustachian tube [2-6]. Alternatively, other studies have found that acute weight loss was associated with Patulous Eustachian tube, probably due to loss of peri-tubal fat [7-9]. Tympanometry is one known method of diagnosing Eustachian tube dysfunction [10]. Our aim from this study is to determine the effects of obesity on Eustachian tube function using tympanometry. This study was done in a tertiary care hospital in Riyadh, Saudi Arabia. We included 82 Saudi adult patients. In our population, we found no statistically significant difference in the Eustachian tube function between obese and non obese patients. Further studies with a larger sample size and different methods of Eustachian tube function assessment might be needed for better understanding of the relationship between obesity and Eustachian tube function. Introduction Eustachian tube dysfunction is estimated to occur in approximately 4% of adults worldwide as a chronic condition, however, it can present as an intermittent problem in an unknown but higher percentage. It is believed that Obesity (defined by WHO as body mass index of 30 or more) [1] can increase the risk of Eustachian tube dysfunction because of fatty deposits accumulation around the Eustachian tube [2]. Several studies have suggested a relationship between pediatric obesity and otitis media with effusion because of fat accumulation around the Eustachian tube [3-6]. On the other hand, other studies have found that acute weight loss following bariatric surgery (probably due to loss of peritubal fat) was found to be associated with Patulous Eustachian tube [7-9]. Tympanometry is a test that is used for indirect measurement of the compliance (mobility) and the impedance of the tympanic membrane together with the condition of the ossicles of the middle ear, which was found to be helpful in the diagnosis of Eustachian tube dysfunction along with other middle ear conditions [10]. Valsalva and Toynbee maneuvers can alter the pressure of the middle ear and thus the position tympanic membrane [11]. Kumazawa et al. [12] described Eustachian tube function testing using tympanometry measurements before and after Valsalva and Toynbee maneuvers. Based on the results they categorized Eustachian tube function into normal, dysfunctional and Patulous Eustachian tube. Our aim from this study is to use the same method that was used by Kumazawa et al. [12] to study the Eustachian tube status in adults, and compare the results between obese and non obese individuals, which to our knowledge has not been done before in Saudi Arabia. Methodology Objectives of the study Aim of the study: To study the relationship between obesity and Eustachian tube dysfunction. Secondary objectives: i. To compare tympanometric measurements between obese and non obese. ii. To compare the effects of Valsalva maneuver on Eustachian tube function between obese and non obese patients.