Abstract
Previous studies have suggested a potential association between deviation of the nasal septum and ear-related symptoms, such as tinnitus. The present study aims to assess the relationships between tinnitus and previous episodes of allergic rhinitis (AR) and chronic rhinosinusitis (CRS) through the use of a nationwide cohort. The research comprised 138,361 patients with tinnitus and 384,895 controls matched on their propensity scores. The baseline clinical and sociodemographic features of both tinnitus patients and the controls were examined utilizing standardized differences. Separate multiple logistic regression models were created to assess the relationship between AR, CRS, and the likelihood of developing tinnitus. Our primary analysis revealed significant differences in the prevalence of pre-existing AR (31.66% vs. 19.64%, p < 0.001), CRS (3.83% vs. 2.15%, p < 0.001), and both (2.51% vs. 1.28%, p < 0.001) between tinnitus patients and controls. Furthermore, tinnitus was significantly associated with pre-existing AR (OR = 1.813, 95% CI:1.787 ~ 1.840), CRS (OR = 1.626, 95% CI:1.569 ~ 1.686), and both (OR = 1.751, 95% CI:1.674 ~ 1.831) after adjusting for sociodemographic traits and medical conditions including hyperlipidemia, diabetes, hearing loss, obesity, anemia, alcohol abuse, tobacco use disorder, anxiety disorder, depressive disorder, asthma and otitis media. This large, population-based study demonstrates a significant association between AR, CRS, and tinnitus, with the highest risk observed in patients affected by both conditions. Early identification and treatment of AR and CRS may help reduce tinnitus risk and improve overall quality of life.
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Data availability
The data that support the findings of this study are not publicly available due the privacy protection regulation of Health and Welfare Data Centre, Ministry of Health and Welfare, Taiwan.
References
Atar Bese, S., Ozdemir, O., Tuncerler, G., Erge, D. & Uysal, P. Do not ignore mouth breathing syndrome: respiratory functions are affected in early childhood. Rhinology 62, 659–668. https://doi.org/10.4193/rhin24.133 (2024).
Ayappa, I. et al. Nasal resistance and inflammation: mechanisms for obstructive sleep apnea from chronic rhinosinusitis. J. Clin. Sleep Med. 20, 1627–1636. https://doi.org/10.5664/jcsm.11216 (2024).
Bengtsson, C. et al. Incident chronic rhinosinusitis is associated with impaired sleep quality: results of the RHINE study. J. Clin. Sleep Med. 15, 899–905. https://doi.org/10.5664/jcsm.7846 (2019).
Bousquet, J., Van Cauwenberge, P. & Khaltaev, N. Allergic rhinitis and its impact on asthma. J. Allergy Clin. Immunol. 108, 147–334. https://doi.org/10.1067/mai.2001.118891 (2001).
Chen, H. J., Lee, Y. J., Yeh, G. C. & Lin, H. C. Association of attention-deficit/hyperactivity disorder with diabetes: a population-based study. Pediatr. Res. 73, 492–496. https://doi.org/10.1038/pr.2013.5 (2013).
Chen, T. et al. Eustachian tube dysfunction (ETD) in chronic rhinosinusitis with comparison to primary ETD: A systematic review and meta-analysis. Int. Forum Allergy Rhinology. 12, 942–951. https://doi.org/10.1002/alr.22942 (2022).
Cheung, I. C. W., Neeff, M., Hussain, S. & Thorne, P. R. Outer hair cell cochlear dysfunction in obstructive sleep apnea patients. Respir. Med. 249, 108454. https://doi.org/10.1016/j.rmed.2025.108454 (2025).
Dydyk, A. M., Chiebuka, E., Stretanski, M. F. & Givler, A. in StatPearls (StatPearls Publishing, (2025).
Ferreira, N. B. et al. Frequency of obstructive sleep apnea in patients with asthma or allergic rhinitis: a systematic review and meta-analysis. Sleep Med. 134, 106705. https://doi.org/10.1016/j.sleep.2025.106705 (2025).
Fortune, D. S., Haynes, D. S. & Hall, J. W. TINNITUS: current evaluation and management. Med. Clin. North Am. 83, 153–162. https://doi.org/10.1016/S0025-7125(05)70094-8 (1999).
Gu, L. et al. Association between mouth breathing and the temporomandibular system: a narrative review. J. Rehabil. 52, 1152–1159. https://doi.org/10.1111/joor.14008 (2025).
Lin, H. C. et al. Increased risk of developing stroke among patients with bipolar disorder after an acute mood episode: A six-year follow-up study. J. Affect. Disord. 100, 49–54 (2007).
Hwang, C. Y. et al. Prevalence of atopic dermatitis, allergic rhinitis and asthma in taiwan: a National study 2000 to 2007. Acta Derm Venereol. 90, 589–594. https://doi.org/10.2340/00015555-0963 (2010).
Lazo-Sáenz, J. G. et al. Eustachian tube dysfunction in allergic rhinitis. Otolaryngology–Head Neck Surg. 132, 626–629. https://doi.org/10.1016/j.otohns.2005.01.029 (2005).
Lin, H. C., Xirasagar, S., Wang, C. H., Cheng, Y. F. & Yang, T. H. Increased risk of major depressive disorder following tinnitus: A Population-Based study. Front. Neurol. 13 https://doi.org/10.3389/fneur.2022.836842 (2022).
Livingston, R. et al. Breathing pattern disorder in chronic rhinosinusitis with severe asthma: nasal obstruction and polyps do not increase prevalence. J. Asthma. 61, 177–183. https://doi.org/10.1080/02770903.2023.2255277 (2024).
Lu, C. T., Lee, L. A., Lee, G. S. & Li, H. Y. Obstructive sleep apnea and auditory dysfunction—does snoring sound play a role? Diagnostics 12, 2374 (2022).
Martines, F. et al. Audiologic profile of OSAS and simple snoring patients: the effect of chronic nocturnal intermittent hypoxia on auditory function. Eur. Arch. Otorhinolaryngol. 273, 1419–1424. https://doi.org/10.1007/s00405-015-3714-6 (2016).
McCray, L. R. et al. Suicidal ideation and behaviors in adults with tinnitus: a systematic review and meta-analysis. Laryngoscope 135, 2653–2661. https://doi.org/10.1002/lary.32118 (2025).
Pandrangi, V. C. & Alt, J. A. Sleep in disease: inflammation and chronic rhinosinusitis. Neurobiol. Sleep. Circadian Rhythms. 18, 100120. https://doi.org/10.1016/j.nbscr.2025.100120 (2025).
Perry, S. K. & Emrick, J. J. Trigeminal somatosensation in the temporomandibular joint and associated disorders. Front. Pain Res. 5 https://doi.org/10.3389/fpain.2024.1374929 (2024).
Phillips, K. M. et al. Acute exacerbations mediate quality of life impairment in chronic rhinosinusitis. J. Allergy Clin. Immunology: Pract. 5, 422–426. https://doi.org/10.1016/j.jaip.2016.09.015 (2017).
Ren, Y. F. & Isberg, A. Tinnitus in patients with temporomandibular joint internal derangement. CRANIO® 13, 75–80. https://doi.org/10.1080/08869634.1995.11678048 (1995).
Stoikes, N. F. N. & Dutton, J. M. The effect of endoscopic sinus surgery on symptoms of eustachian tube dysfunction. Am. J. Rhinol. 19, 199–202. https://doi.org/10.1177/194589240501900214 (2005).
Wang, C. et al. Association between obstructive sleep apnea and tinnitus in the united states: NHANES 2005–2020. Sleep. Breath. 29, 86. https://doi.org/10.1007/s11325-025-03243-0 (2025).
Yang, T. H. et al. Increased prevalence of hearing loss, tinnitus and sudden deafness among patients with Sjögren’s syndrome. RMD Open. 10, e003308. https://doi.org/10.1136/rmdopen-2023-003308 (2024).
Yeo, C. D. et al. Association between nasal septal deviation and tinnitus: insights from a 9-year nationwide cohort study. Medicine 103, e40208. https://doi.org/10.1097/md.0000000000040208 (2024).
Pawankar, R. Inflammatory mechanisms in allergic rhinitis. Curr. Opin. Allergy Clin. Immunol. 7, 1–4. https://doi.org/10.1097/ACI.0b013e3280145347 (2007).
Shore, S. E. et al. Maladaptive plasticity in tinnitus- triggers, mechanisms and treatment. Nat. Rev. Neurol. 12, 150–160. https://doi.org/10.1038/nrneurol.2016.12 (2016).
Fokkens, W. J. et al. EPOS/EUFOREA update on indication and evaluation of biologics in chronic rhinosinusitis with nasal polyps. Rhinology 61, 194–202. https://doi.org/10.4193/Rhin22.489 (2023).
Bowles, P. F. D. et al. Eustachian tube dysfunction in chronic rhinosinusitis: pre and post-operative results following endoscopic sinus surgery, a prospective study. Rhinology 57, 73–77. https://doi.org/10.4193/rhin18.208 (2019).
Lu, C. T. et al. Obstructive sleep apnea and auditory dysfunction-does snoring sound play a role? Diagnostics (Basel) 12, (2022). https://doi.org/10.3390/diagnostics12102374
Vanneste, S. & De Ridder, D. The auditory and non-auditory brain areas involved in tinnitus. An emergent property of multiple parallel overlapping subnetworks. Front. Syst. Neurosci. 6, 31. https://doi.org/10.3389/fnsys.2012.00031 (2012).
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The authors thank the Health and Welfare Data Science Center (HWDC), Ministry of Health and Welfare, Taiwan, for providing the data.
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Conceptualization, TH and HC; methodology, TC; validation, TC; formal analysis, TC; writing—original and revision preparation, TH, SD, HC, and TC.; writing review and editing, HC. All authors have read and agreed to the published version of the manuscript.
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Yang, TH., Chung, SD., Lin, HC. et al. Associations of chronic rhinosinusitis and allergic rhinitis with tinnitus. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39016-2
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DOI: https://doi.org/10.1038/s41598-026-39016-2


