Tympanometric changes and eustachian tube function in patients with hypothyroidism

Rhinitis in patients with acquired hypothyroidism

OBJECTIVES

Our aim was to evaluate the rhinological changes during hypothyroid and euthyroid periods in patients with acquired hypothyroidism.

MATERIALS AND METHODS

The newly diagnosed 40 adult patients with hypothyroidism who presented to the Endocrinology clinic at a tertiary hospital were enrolled in the study. Patients having blood thyroid-stimulating hormone levels greater than 4.95 IU/dl were consulted to the ENT clinic. Nasal Obstruction Symptom Evaluation scores, Peak Nasal Inspiratory Flow rates and nasal mucociliary clearance time of patients were noted before and 4 months after the oral levothyroxine sodium tablet treatment.

RESULTS

Of the patients included in the study, 34 (85%) were females and 6 (15%) were males. The mean thyroid-stimulating hormone values before the treatment was 10.01 ± 3.31 IU/dl and 4.03 ± 2.45 IU/dl at the end of the treatment. The difference in values was statistically significant (p < 0.001). The mean mucociliary clearance time before treatment was 8.03 ± 3.29 min and 7.35 ± 2.87 min at the end of treatment. The decrease in mucociliary clearance time was statistically significant (p = 0.001). We did not detect any significant difference between pre- and posttreatment values of nasal obstruction symptom evaluation scores and peak nasal inspiratory flow rates.

CONCLUSION

The patients with hypothyroidism have prolonged mucociliary clearance time in hypothyroid period of the disease. Regarding to this data, we may recommend clinicians to follow-up these patients more closely for respiratory tract diseases and sinonasal infections.

Preliminary Study on Antinuclear Antibodies in Patients With Chronic Dilatory Eustachian Tube Dysfunction

BACKGROUND AND HYPOTHESIS

There are some known reasons for chronic dilatory Eustachian tube dysfunction (chronic D-ETD, also known as chronic obstructive tube dysfunction), for example infections, hyperplastic adenoids, or tumors. In many cases though, none of these reasons apply. The question arises whether there might be an autoimmune pathogenesis in patients with idiopathic chronic D-ETD.

METHODS

The study includes 31 consecutive patients with chronic D-ETD and 92 consecutive blood donors (BD, comparative cohort). The production of antinuclear antibodies (ANA), as an indicator for autoimmune pathologies, was measured in the serum of patients and BD.

RESULTS

ANA titers were significantly higher in patients with chronic D-ETD, compared with BD (p = 0.0027). The results weighted clearly toward higher ANA titers in younger patients. A comparison of ANA titers in patients and BD aged less than 40 years showed a significant difference (p = 0.0062), whereas it was not significant between patients and BD aged ≥ 40 years (p = 0.19).

CONCLUSION

The significant results of elevated ANA titers in chronic D-ETD make an autoimmune pathogenesis highly probable, at least in some of the patients concerned. Further research with higher numbers of patients is needed to confirm the hypothesis of an autoimmune chronic D-ETD. A better understanding of etiology and pathogenesis of chronic D-ETD might open up new and perhaps even causal therapeutic strategies.