Randomized evaluation of the audiologic outcome of ventilation tube insertion for middle ear effusion in patients with nasopharyngeal carcinoma.
OBJECTIVE
Complications after ventilation tube insertion for middle ear effusion in patients with nasopharyngeal carcinoma are frequent. This may compromise the overall benefit obtained from the procedure. This study evaluates the hearing improvement after tube insertion compared with observation alone to see if the benefits of the procedure outweigh its potential complications.


METHODS
Prospective randomized controlled trial.


METHODS
Full clinical and emergency otolaryngologic services hospital in an academic institution.


METHODS
Patients with nasopharyngeal carcinoma and middle ear effusion were randomized for preradiotherapy ventilation tube insertion or observation. Audiologic assessment with a pure-tone audiogram was performed before the procedure, after ventilation tube insertion, and at fixed intervals after irradiation. Audiologic outcome was compared between the two groups.


METHODS
Air-conduction threshold and air-bone gap on a pure-tone audiogram at different intervals after radiotherapy.


RESULTS
There was no significant difference in hearing threshold changes between the two groups for up to 4 years. Both groups had air-bone gap improvement following radiotherapy and the improvement was not significantly different between the two groups. The proportion of patients with closure of the air-bone gap on follow-up was not different between the two groups.


CONCLUSIONS
Ventilation tube insertion before radiotherapy did not offer additional hearing benefit when compared with observation alone. The procedure had no deleterious effect on hearing for up to 4 years.
Ho
Wai-kuen
WK
Department of Surgery, Division of Otorhinolaryngology-Head and Neck Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong, PR China.
Wei
William I
WI
Kwong
Dora L W
DL
Sham
Jonathan S T
JS
Au
Dennis K K
DK
Chua
Daniel T T
DT
Choy
Damon T K
DT
D000328:Adult; D001301:Audiometry, Pure-Tone / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology* / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000379:methods*; D009303:Nasopharyngeal Neoplasms / Q000150:complications* / Q000473:pathology* / Q000532:radiotherapy; D010034:Otitis Media with Effusion / Q000150:complications* / Q000601:surgery*; D011829:Radiation Dosage; D012720:Severity of Illness Index