The treatment for postirradiation otitis media with effusion: a study of three methods.
OBJECTIVE
To explore treatments for postirradiation otitis media with effusion (OME) in patients with nasopharyngeal carcinoma.


METHODS
This study is a prospective quasi-randomized clinical trial.


METHODS
Ninety-six patients (135 ears) with OME after the first course of radiotherapy for nasopharyngeal carcinoma were divided into three groups: simple auripuncture plus aspiration, tympanic membrane fenestration with cauterization, and myringotomy plus grommet insertion. Cure rates and incidences of complications were compared.


RESULTS
Two deaths occurred. The other 94 patients (132 ears) finished a 2-year follow-up. In group 1, four ears (8.9%) were cured after the first treatment and 17 ears overall (37.8%) were cured by the end of the follow-up. Twenty ears (44.4%) had persistent fluid, two ears (4.4%) developed chronic suppurative otitis media, and five ears (11.1%) developed dry eardrum perforation. In group 2, seven ears (15.6%) were cured after the first treatment and 21 ears overall (46.7%) were cured by the end of the follow-up. Fourteen ears (31.1%) had persistent fluid, three ears (6.7%) developed chronic suppurative otitis media, and seven ears (15.6%) developed dry eardrum perforation. In group 3, eight ears (17.8%) were cured after the first treatment and 23 ears overall (51.1%) were cured by the end of the follow-up. Seven ears (15.6%) had persistent fluid, five ears (11.1%) developed chronic suppurative otitis media, three ears (6.7%) developed eardrum perforation with effusion, and five ears (11.1%) developed dry eardrum perforation.


CONCLUSIONS
The methods each have advantages and disadvantages. We believe that a step by step approach should be used when choosing the treatment method for postirradiation OME. That is, first apply auripuncture plus aspiration, and then the other methods if this approach is inadequate. Enhanced local care after grommet insertion can effectively reduce the incidence of complications.
Xu
Yao-Dong
YD
Department of Otolaryngology, Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Ou
Yong-Kang
YK
Zheng
Yi-Qing
YQ
Chen
Yong
Y
Ji
Shu-Fang
SF
D000328:Adult; D000368:Aged; D002424:Caustics / Q000627:therapeutic use; D002425:Cautery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000379:methods*; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy; D010034:Otitis Media with Effusion / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D011832:Radiation Injuries / Q000150:complications*; D013396:Suction / Q000379:methods; D016896:Treatment Outcome; D014238:Trichloroacetic Acid / Q000627:therapeutic use; D014432:Tympanic Membrane / Q000601:surgery*
D002424:Caustics; D014238:Trichloroacetic Acid