We know that chronic rhinosinusitis (CRS) and Eustachian tube dysfunction (ETD) are both very common, and that the two often co-exist but this paper looks to establish the prevalence and severity of ETD in CRS patients, and how much treatment for CRS can improve ETD symptoms. Using a SNOT-22 questionnaire to establish the severity of CRS symptoms in a cohort of patients undergoing FESS, and an ETDQ-7 questionnaire to establish severity of ETD symptoms, the authors sought to establish how these symptom scores correlated and how they responded to FESS. It is unsurprising that they found a correlation between the ear/facial subdomain of the SNOT-22 and the ETDQ-7 as the questions are very similar. It is interesting to note that the mean ETDQ-7 score in this entire patient group was 15.8 +/- 8.8, and that 47.6% of patients had an ETDQ-7 score greater than 14.5 which signifies clinically significant ETD symptoms. In these who returned their questionnaires, the mean ETDQ-7 score improved from 16.8 to 12.7 following FESS. I wonder if there is a role for concurrent FESS and ET balloon surgery to try to further improve symptom scores in these patients; a study to look at this would be very interesting.