Nasopharyngeal carcinoma and middle ear effusion: natural history and the effect of ventilation tubes.

Middle ear effusion is a common occurrence in nasopharyngeal carcinoma, and is often treated by myringotomy and ventilation tube insertion. However, this can be complicated by a high rate of otorrhoea after radiotherapy. The natural history and management of middle ear effusion was examined in this retrospective study of 81 patients. An effusion was noted in 52% of patients at presentation and developed in 26% of patients after radiotherapy. At the end of the observation period there was no difference in the rate of resolution of effusions in patients with ventilation tubes insertion compared with patients with no tube insertion. A significantly greater incidence of otorrhoea and persistent perforation was found in patients with tubes (P = 0.0497). When otorrhoea occurred it was often persistent and troublesome, and so conservative management of effusions in patients with nasopharyngeal cancer should be considered.