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The effectiveness of myringotomy and ventilation tube insertion versus observation in post-radiation otitis media with effusion

  • Otology
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Abstract

To compare the effectiveness of myringotomy and ventilation tube insertion versus observation in post-radiation otitis media with effusion (OME) in nasopharyngeal carcinoma (NPC). NPC patients who finished radiotherapy and had persistent OME were randomized to myringotomy and ventilation tube insertion and observation groups. The resolution rate of OME and hearing outcomes were evaluated. Forty three patients (23 in control group and 20 in intervention group) were analyzed. One patient in the control group obtained a resolution of OME. The remaining patients in the control group had persistent middle ear fluid. Fourteen patients in the intervention group had retained ventilation tubes without otorrhea. Ventilation tubes had spontaneously extruded in the remaining six patients and all of these patients had recurrent OME. Mean air-pure tone average in the control group was 52.04 dB (SD 11.61), significantly different from the intervention group [38.15 dB (SD 19.10); p = 0.01]. Mean air-bone gap in the control and intervention groups were 27.30 dB (SD 9.11) and 9.30 dB (SD 9.59) respectively (p < 0.001). Mean air-pure tone average and mean air-bone gap improvement was significantly improved in the intervention group (p < 0.001). Two patients in the intervention group (10%) developed complications, one patient suffering suppurative otitis media whilst another had otorrhea, which resolved after 1-week course of antibiotic treatment. Post-radiation OME is common in patients with NPC and tends to persist long-term. Conservative management is safe, however, is plagued by frustrating effects of hearing impairment and aural fullness. Myringotomy with ventilation tube insertion leads to hearing improvement with few complications.

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Acknowledgements

The author would like to express sincere appreciation to Faculty of Medicine, Chulalongkorn University for funding this study, Dr. Chakkapong Chakkabat for radiation dose information and Dr. Annabelle Leong for manuscript revision.

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  1. Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand

    Paninee Charusripan & Likhit Khattiyawittayakun

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  1. Paninee Charusripan
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  2. Likhit Khattiyawittayakun
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Correspondence to Paninee Charusripan.

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Funding

This study was funded by Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University (Grant Number 2558-078)

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The author Paninee Charusripan declares that she has no conflict of interest. The author Likhit Khattiyawittayakun declares that he has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Charusripan, P., Khattiyawittayakun, L. The effectiveness of myringotomy and ventilation tube insertion versus observation in post-radiation otitis media with effusion. Eur Arch Otorhinolaryngol 274, 3283–3290 (2017). https://doi.org/10.1007/s00405-017-4617-5

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  • DOI: https://doi.org/10.1007/s00405-017-4617-5

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