{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:14:16Z","timestamp":1789820056131,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the effect of smoking history on the risk of developing obstructive eustachian tube dysfunction (OETD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from the National Health and Nutrition Examination Survey (1999 to present) was analyzed. OETD was defined as middle ear pressure less than \u2212100\u2009decapascals (daPa). Nonsmokers, current smokers, with tympanometry data were analyzed. Patients under the age of 18, with myringotomy tubes, or with a sinus problem\/earache\/cold in the past 24\u00a0hours were excluded. The relative risks (RRs) for developing OETD were calculated for nonsmokers versus smokers and those with greater versus less than 10, 20, and 30\u2009pack years (py).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 9472 patients met inclusion criteria (54.1% female, 75.9% non\u2010Hispanic, mean age 43, 20.3% smokers). The RR of having OETD for smokers versus nonsmokers was 1.75 [95% confidence interval, CI: 1.45\u20102.11]. The RR of having OETD for patients with a 10+\u2009py was 1.97 [95% CI 1.57\u20102.47], 20+\u2009py was 2.29 [95% CI 1.76\u20102.95], and 30\u2009py or greater was 2.08 [95% CI 1.49\u20102.90].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, smoking roughly doubled the risk of developing OETD, as represented by a single measurement of negative middle ear pressure less than \u2212100\u2009daPa. The definition of OETD used in this study was limited, as it did not include symptomology, and more work is needed to examine additional covariates. However, these results may guide future research to better counsel and screen patients for OETD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oto2.166","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T11:22:43Z","timestamp":1720178563000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Smoking Pack Years and Eustachian Tube Dysfunction"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7575-200X","authenticated-orcid":false,"given":"Arjun","family":"Sharma","sequence":"first","affiliation":[{"name":"School of Medicine California University of Science and Medicine Colton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"MacDowell","sequence":"additional","affiliation":[{"name":"School of Medicine California University of Science and Medicine Colton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2472-7126","authenticated-orcid":false,"given":"Nihal","family":"Punjabi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Loma Linda University Health Loma Linda California USA"},{"name":"School of Medicine Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Kejriwal","sequence":"additional","affiliation":[{"name":"John A. Burns School of Medicine University of Hawaii Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Sharma","sequence":"additional","affiliation":[{"name":"College of Letters and Sciences University of California, Los Angeles Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared C.","family":"Inman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12475"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.1917"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819848423"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820965236"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0163926"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2020.0962"},{"issue":"4","key":"e_1_2_8_8_1","first-page":"260","article-title":"Tympanometric measures in older adults","volume":"7","author":"Wiley TL","year":"1996","journal-title":"J Am Acad Audiol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2022.07.010"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2022.103581"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.25122\/jml-2023-0254"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.5935\/0946-5448.20170019"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.158"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.298.6687.1549"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1617-9625-10-4"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29887"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.121320"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30841-9"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.04.135"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S149382"},{"key":"e_1_2_8_21_1","unstructured":"NCHS.National Health and Nutrition Survey.\u00a0Center for Disease Control and Prevention; 1999\u20102018."},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200604000-00023"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2008.07.009"},{"key":"e_1_2_8_24_1","volume-title":"Robbins Basic Pathology","author":"Kumar V","year":"2017"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-023-02533-1"},{"issue":"3","key":"e_1_2_8_26_1","first-page":"7","article-title":"Outcome of smoking cessation on airway remodeling and pulmonary inflammation in COPD patients","volume":"10","author":"Mortaz E","year":"2011","journal-title":"Tanaffos"}],"container-title":["OTO Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/oto2.166","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:20:38Z","timestamp":1760952038000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/oto2.166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1002\/oto2.166"],"URL":"https:\/\/doi.org\/10.1002\/oto2.166","archive":["Portico"],"relation":{},"ISSN":["2473-974X","2473-974X"],"issn-type":[{"value":"2473-974X","type":"print"},{"value":"2473-974X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2024-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e166"}}