title: Randomized evaluation of the audiologic outcome of ventilation tube insertion for middle ear effusion in patients with nasopharyngeal carcinoma.
abstract: 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.
authors.affiliation: Department of Surgery, Division of Otorhinolaryngology-Head and Neck Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong, PR China.
authors.forename: Wai-kuen
authors.initials: WK
authors.lastname: Ho
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
authors.forename: Dora L W
authors.initials: DL
authors.lastname: Kwong
authors.forename: Jonathan S T
authors.initials: JS
authors.lastname: Sham
authors.forename: Dennis K K
authors.initials: DK
authors.lastname: Au
authors.forename: Daniel T T
authors.initials: DT
authors.lastname: Chua
authors.forename: Damon T K
authors.initials: DT
authors.lastname: Choy
mesh_terms: 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