Early recognition of nasopharyngeal cancer in adults with only otitis media with effusion.
OBJECTIVE
To assess the probability of nasopharyngeal carcinoma (NPC) being present among adults who appeared to suffer only from otitis media with effusion (OME).


METHODS
The clinical features of 87 adults suffering from OME but who demonstrated no other apparent symptoms and signs suggestive of NPC at the Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, between January 2003 and December 2004, were analyzed. A routine nasopharyngeal biopsy was performed.


RESULTS
Five patients revealed NPCs (four nonkeratinizing carcinomas and one squamous cell carcinoma). OME was deemed to have resulted from upper respiratory infection in 20 patients (23.0%), chronic paranasal sinusitis in 15 patients (17.3%), allergic rhinitis in 16 patients (18.4%), NPC in 5 patients (5.7%), various other known etiologies in 11 patients (12.6%), and unknown etiologies in 20 patients (23.0%). The incidence of NPC among adults suffering from OME but featuring no other symptoms and signs suggestive of NPC was 5.7% (5 of 87 patients). Such a figure appeared to be greater than that in some other reports because NPC tends to feature a greater prevalence in Taiwan. Therefore, biopsy of the postnasal space for adults who appear to feature only OME when NPC is strongly suspected is necessary for the early diagnosis of NPC.


CONCLUSIONS
We conclude that Taiwanese adults with only OME, the cause of which is unclear, should be subjected to an appropriate medical examination and biopsy of the nasopharynx to exclude NPC.
Ho
Kuen-Yao
KY
Department of Otolaryngology, Kaohsiung Medical University Hospital, and Department of Otolaryngology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
Lee
Ka-Wo
KW
Chai
Chee-Yin
CY
Kuo
Wen-Rei
WR
Wang
Hsun-Mo
HM
Chien
Chen-Yu
CY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000150:complications / Q000175:diagnosis*; D009305:Nasopharynx / Q000473:pathology; D010034:Otitis Media with Effusion / Q000150:complications* / Q000175:diagnosis; D015995:Prevalence; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult