title: [Retrospective results of radiation therapy of the eustachian tube in chronic otitis media].
abstract: BACKGROUND
  The treatment results of symptomatic radiation therapy of the Eustachian tube in chronic otitis media had to be evaluated retrospectively.
  
  
  METHODS
  Between 1980 and 1997, 66 patients were referred for therapy. The median age was 58 years. In the clinical presentation, all the patients had a hearing impairment, 35 patients complained of pain, 21 had otorrhea. In their history, 20 patients indicated chronic recurrent infections. The complaints lasted for 4.7 years in the median, primary conservative (adstringentia, antibiotics) and surgical treatment (paracentesis, tympanic tubule, tympanoplastic) did not lead to lasting cure. In 40 of 66 patients, finally radiation therapy was done of both Eustachian tubes. With opposed fields and cobalt-60 photons a total dose of 6 Gy at single doses of 1 Gy, three times a week, was applied. Under the causes for exclusion of radiation therapy were non-acceptance of the patients (nine), prior radiation therapies (six) or spontaneous improvement after initial presentation in our department. The treatment results were evaluated by interviews of the patients and regular otorhinolaryngological examinations.
  
  
  RESULTS
  There were no side effects noticed. 28 of 40 (70%) patients reported a significant improvement that could be verified by objective otorhinolaryngological examinations. In the group of 26 nonirradiated patients, 22 could be interviewed indicating in 16 cases (72%) that the complaints were unchanged and chronic otitis media was lasting. In a subgroup analysis concerning the duration of otitis media radiation therapy proved more effective in an acute and subacute stadium of disease of up to 5 years duration, while the patients resistant to radiation therapy were entirely in a chronic stage of disease exceeding 5 years duration.
  
  
  CONCLUSIONS
  Radiation therapy is an effective tool for symptomatic improvement of the therapy-resistant chronic otitis media. A dose of 6 Gy seems to be sufficient to achieve an antiinflammatory effect. Radiotherapy should be applied earlier after initial conservative and surgical treatment.
authors.affiliation: Klinik für Strahlentherapie (Radioonkologie), Universitätsklinikum Kiel, Germany. schultze@nco.uni-kiel.de
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schultze
authors.forename: Constantin
authors.initials: C
authors.lastname: Reinke
authors.forename: Knut Arvid
authors.initials: KA
authors.lastname: Frese
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kimmig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis / Q000209:etiology / Q000532:radiotherapy*; D002908:Chronic Disease; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D005064:Eustachian Tube / Q000528:radiation effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000209:etiology / Q000532:radiotherapy*; D011867:Radioisotope Teletherapy; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies
chemical_list: D003037:Cobalt Radioisotopes