Current management of adults with persistent unilateral otitis media with effusion: survey of UK otolaryngologists.

BACKGROUND

Persistent unilateral Otitis Media with Effusion (OME) in adults is a recognised presenting feature of nasopharyngeal carcinoma (NPC). Currently, there is no guideline-driven consensus on the optimal investigation and management for this cohort.

AIM: This study aims to capture current approaches for the management of Persistent unilateral otitis media with effusion (OME) in adults among UK otolaryngologists.

MATERIAL AND

METHODS

An anonymised survey was developed and piloted locally among consultants at Sheffield Teaching Hospitals (STH) Trust before national distribution to ENT UK members via newsletters in November 2024 and January 2025. Responses from consultant and non-consultant grades were analysed.

RESULTS

A total of 105 clinicians (45 consultants, 60 non-consultants) responded. Initial management varied, with intranasal steroids (48.6%), auto-inflation exercises (43.8%) and expectant management (37.7%) most common. MRI was requested selectively, mainly for abnormal nasendoscopic findings. Examination under anaesthesia was reserved for suspicious cases, and malignancy in a clinically normal nasopharynx was rarely reported.

CONCLUSIONS AND SIGNIFICANCE: Significant variation in practice exists, highlighting the need for an evidence-based diagnostic pathway for suspected NPC that balances early disease detection with avoidance of unnecessary investigations.