Distinct mechanisms of otitis media with effusion before/after treatment in nasopharyngeal carcinoma.

OBJECTIVE

Otitis media with effusion (OME) is common in nasopharyngeal carcinoma (NPC), but its pre- and post-treatment forms may represent distinct clinical entities. This study aimed to compare tumor- and host-related risk factors between pre- and post-treatment OME in NPC.

METHODS

This retrospective cohort study included 31 patients with newly diagnosed NPC treated at a tertiary referral center. Clinical, radiologic, and otologic data were reviewed. Associations between clinical parameters and the presence of pre- and post-treatment OME were evaluated. Tumor-related factors, including T classification and magnetic resonance imaging-defined involvement of the tensor veli palatini muscle (TVPM), as well as host-related factors such as mastoid pneumatization, were analyzed.

RESULTS

Pre-treatment OME was observed in 19 of 29 patients (66%) and was significantly associated with advanced primary tumor classification (T2-4 vs T1; p = 0.03) and involvement of the TVPM (p = 0.01). In contrast, post-treatment OME occurred in 14 of 31 patients (45%) and showed no significant association with tumor extent, nodal status, or TVPM involvement. Instead, poor mastoid pneumatization was significantly associated with post-treatment OME (p = 0.05). Persistent OME before and after treatment was observed in 10 of 29 patients (35%), indicating that tumor control does not necessarily result in resolution of middle ear effusion.

CONCLUSION

OME in NPC comprises biologically distinct entities before and after treatment. Pre-treatment OME is primarily driven by tumor-related anatomical factors, whereas post-treatment OME is more strongly associated with host-related factors including mastoid pneumatization.