An endoscopic study of tubal function and the diseased ethmoid sinus.

Diseases of the paranasal sinuses--especially of the anterior ethmoid sinus--may affect tubal function. Acute and chronic sinus inflammations cause alterations in the normal pathways for secretions out of the sinus system. The normal secretion pathways usually bypass the orifice of the eustachian tube in the nasopharynx. Excessive or infected mucus can then be transported directly over the tubal orifice to cause its obstruction and promote ascending infections into the middle ear. We have found that nasal endoscopy proves to be very helpful in detecting even "hidden" pathologies due to sinus disease in key areas in the middle meatus, and furthermore allows a direct visualization of the tubal orifice. Functional endoscopic surgery has also enabled us to clear diseased and stenotic areas involving the sinus ostia with minimal procedures. Normal drainage and ventilation are reestablished via the physiologic sinus ostia and thus help to normalize tubal function.