Some ear conditions are ultimately related to the nose.  Once you think about the intertwined anatomy and physiology of these two body parts, it makes complete sense. The nose is connected to the ear via a functional tube called the Eustachian tube. This tube helps ventilate, drain, and maintain an equilibrium of air pressure in the middle ear. It opens in the back of the nose called the nasopharynx. If something were to block that opening, the system gets backed up, causing increased ear pressure and ear fluid.

We have known that one of the causes of ear infections or persistent middle ear fluid in kids is obstruction of the Eustachian tube from the adenoids, which are in the nasopharynx. Thus, performing an adenoidectomy is one of the treatments for chronic ear fluid in kids.

Our research group set out to see if chronic rhinosinusitis affected ear symptoms in adults and our findings were significant. We found that, in patients with chronic rhinosinusitis, ear symptoms and nose/sinus symptoms were strongly correlated.  So, those with worse sinus symptoms seemed to have worse ear symptoms.

We also looked at how sinus surgery affected ear symptoms. In this study, 80% of the patients had improvement in ear symptoms with sinus surgery alone and 60% had complete resolution (or normalization) of their ear symptoms!

So, we have found it important to ask questions about both nose and ear symptoms because treating the nose is often the answer to solving certain ear problems.    

Nasal surgery provides many benefits in the treatment of obstructive sleep apnea (OSA), says the American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS). Nasal surgery is considered any surgery of the nasal passages to improve nasal breathing, such as septoplasty and inferior turbinate reduction. According to the AAOHNS Position Statement from September 8, 2017, here are four evidence-based benefits of nasal surgery in OSA.

1. Nasal surgery improves the use of Continuous Positive Airway Pressure (CPAP), the mainstay treatment for OSA. Many people do not tolerate CPAP, often throwing the mask off in the middle of the night.  A CPAP mask on the nightstand doesn't help at all! 

2. Nasal surgery may improve the use of oral appliances. Oral appliances are used to pull the jaw and/or tongue forward at night to open the airway. A couple of studies have shown that many of the people who are unable to tolerate such appliances are those with higher nasal resistance, so reducing nasal resistance could improve compliance.  

3. Nasal surgery improves quality of life in people with OSA. Two quality-of-life scales, the Epworth Sleepiness Scale and the SF-36, improve significantly after nasal surgery, with decreases in excessive sleepiness along with improved general health and mental health scores.

4. Nasal surgery can reduce the severity of OSA in some people. A few studies, including a randomized control trial, showed improvement in OSA severity, after nasal surgery alone. These results certainly do not indicate that nasal surgery is the cure for OSA, but they do show direct beneficial effects of nasal surgery on OSA. 

The evidence currently shows that nasal surgery provides benefit to OSA sufferers.  Can it take away OSA? Usually not, but it can help make the treatment easier. Thanks for reading this article. Don't forget to check out other related topics, including septoplasty, inferior turbinate reduction, and functional endoscopic sinus surgery. 
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Ref: http://www.entnet.org/content/nasal-surgery-and-osas# (accessed 5/20/2018)