Does Eustachian Tube Dysfunction Influence the Prognosis of Meniere's Disease?

Objective This study aimed to examine the clinical impact of Eustachian tube dysfunction (ETD) on the treatment outcomes of Meniere's disease (MD). Design Retrospective study. Setting Tertiary referral centre. Participants A total of 287 MD patients admitted between January 2015 and June 2024 were included. Main Outcome Measures The primary outcomes included improvement in vertigo and relief of aural fullness. Clinical parameters and treatment outcomes were compared between MD patients with and without ETD and between patients treated by ESS alone versus ESS combined with balloon dilatation of the Eustachian tube (BDET). Propensity score matching (PSM) was performed to balance group differences. Logistic regression was conducted to evaluate the prognostic value of BDET in relieving aural fullness. Results Of the 287 patients with MD, 96 (33.4%) had ETD. Patients with ETD showed a significantly shorter disease duration compared to patients without ETD ( p = 0.041) and experienced more severe aural fullness symptoms (61.5% vs. 48.7%, p = 0.041). After adjusting for age, sex and initial hearing threshold using PSM, the ETD group continued to demonstrate a significantly shorter disease duration than matched controls (median 2 years [IQR 0.5, 5] vs. 3 years [IQR 1, 7.75]; p = 0.003). Patients receiving ESS combined with BDET reported a significantly higher rate of subjective aural fullness relief than patients treated with ESS alone (69.2% vs. 30%, p = 0.002), as well as a higher proportion of Class A vertigo improvement. Logistic regression confirmed that ESS combined with BDET significantly correlated with improved aural fullness (OR = 4.40, 95% CI: 1.41–15.79, p = 0.010). Conclusions For patients whose initial treatments were unsuccessful, combining ESS with BDET may provide greater improvements in aural fullness and vertigo symptoms compared to ESS alone.