Common sense suggests that tinnitus and deafness are ear diseases. In fact, in many cases, the origin of tinnitus and deafness is sinusitis. In other words, tinnitus and deafness may be the result of sinusitis! Tinnitus and deafness caused by sinusitis is more common during early childhood and childhood (before the age of 13).
How does sinusitis cause tinnitus and deafness?
It turns out that the inflammatory secretions from sinusitis can enter the middle ear cavity through the eustachian tube, and as a result of the constant flow of infectious material through this pathway, otitis media persists, resulting in tinnitus and deafness.
The eustachian tube is a tube that communicates between the tympanic chamber and the nasopharynx, with a total length of about 35 mm in adults, and the mouth of the eustachian tube is about 2 to 2.5 cm above the pharynx. In children, the eustachian tube is close to the horizontal, the lumen is shorter, nearly half of that of adults, and the inner diameter is wider, so it is easier for sinus infections in children to invade the tympanic chamber through this tube.
In the clinical management of patients with tinnitus and deafness, especially in young children, special attention should be paid to exclude the possibility of sinusitis as the pathological basis of otitis media.
It should be emphasized that some sinusitis without nasal polyps may not have typical nasal symptoms at the time of consultation, but may have dizziness, head swelling, easy fatigue, and memory loss or poor academic performance, which are very easy to miss clinically. These patients with tinnitus and deafness caused by otitis media, especially young children or children, often neglect to examine and confirm the diagnosis of sinusitis that triggers otitis media in the diagnosis and treatment of tinnitus and deafness. This leads to long-term misdiagnosis and mistreatment.
Diagnostic strategy: Based on the history and presentation, combined with the clinical examination results, it is generally not difficult to diagnose otitis media. However, if sinusitis is diagnosed as the cause of otitis media, a coronal CT scan of the sinuses must be performed to confirm the diagnosis.
Treatment strategy: When sinusitis is diagnosed as the cause of otitis media by coronal CT scan, treatment of sinusitis should be the main focus, taking into account the treatment of otitis media.