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Outcomes of examination under anaesthesia of post-nasal space and grommet insertion in adults presenting with otitis media with effusion

Published online by Cambridge University Press:  03 June 2021

H Mohammed ,
M H Qureshi  and
P Yates
H Mohammed*
Affiliation:
Department of ENT, Freeman Hospital, Newcastle upon Tyne, UK
M H Qureshi
Affiliation:
Department of Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
P Yates
Affiliation:
Department of ENT, Freeman Hospital, Newcastle upon Tyne, UK
*
Author for correspondence: Mr Hassan Mohammed, Department of ENT, Freeman Hospital, Freeman Road, Newcastle upon Tyne, UK E-mail: [email protected]
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Abstract

Background

In adults, otitis media with effusion causes considerable morbidity and has poorly established outcomes. A small number of nasopharyngeal carcinoma patients present with isolated ear-related symptoms. The investigation of choice for these patients is a point of debate.

Methods

A retrospective cohort study was conducted using a local database of adult patients who underwent examination under anaesthesia of the post-nasal space with grommet insertion for otitis media with effusion between January 2014 and January 2016.

Results

Ninety-eight patients met the inclusion criteria. Follow-up duration ranged from 39 to 63 months. Complications of grommets were present in 36 out of 98 patients (36.73 per cent). The findings of examination under anaesthesia of the post-nasal space were documented as abnormal in three patients. No patient was diagnosed with nasopharyngeal carcinoma.

Conclusion

Grommets in adults with otitis media with effusion as the sole presenting feature carry a high complication rate, especially in those with previously inserted grommets. Examination under anaesthesia of the post-nasal space offers a low yield. A magnetic resonance imaging scan of the post-nasal space may be a more sensitive alternative.

Keywords

NasopharynxNasopharyngeal CancerMiddle Ear VentilationMiddle Ear Effusion
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 7 , July 2021 , pp. 620 - 624
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Mr H Mohammed takes responsibility for the integrity of the content of the paper

References

Mills, R, Hathorn, I. Aetiology and pathology of otitis media with effusion in adult life. J Laryngol Otol 2016;130:418–24CrossRefGoogle ScholarPubMed
Sheu, SH, Ho, KY, Kuo, WR, Juan, KH. The probability of diagnosis of nasopharyngeal carcinoma in patients with only adult-onset otitis media with effusion. Kaohsiung J Med Sci 1998;14:706–9Google ScholarPubMed
Dempster, JH, Simpson, DC. Nasopharyngeal neoplasms and their association with adult onset otitis media with effusion. Clin Otolaryngol Allied Sci 1988;13:363–5CrossRefGoogle ScholarPubMed
Gaze, MN, Keay, DG, Smith, IM, Hardcastle, PF. Routine nasopharyngeal biopsy in adult secretory otitis media. Clin Otolaryngol Allied Sci 1992;17:183–4CrossRefGoogle ScholarPubMed
Abu-Ghanem, S, Neiderman, N, Horowitz, G, Yehuda, M, Leshno, M, Abu-Ghanem, Y et al. Nasopharyngeal biopsy in adults: a large-scale study in a non endemic area. Rhinology 2015;53:142–8CrossRefGoogle Scholar
Cunniffe, HA, Gona, AK, Phillips, JS. Should adults with isolated serous otitis media be undergoing routine biopsies of the post-nasal space? J Laryngol Otol 2020;134:811–13CrossRefGoogle Scholar
Glynn, F, Keogh, IJ, Ali, TA, Timon, CI, Donnelly, M. Routine nasopharyngeal biopsy in adults presenting with isolated serous otitis media: is it justified? J Laryngol Otol 2006;120:439–41CrossRefGoogle ScholarPubMed
Yung, MW, Arasaratnam, R. Adult-onset otitis media with effusion: results following ventilation tube insertion. J Laryngol Otol 2001;115:874–8CrossRefGoogle ScholarPubMed
Ogawa, H. Otitis media with effusion: a study of 346 cases in an outpatient clinic [in Japanese]. Nihon Jibiinkoka Gakkai Kaiho 2002;105:863–72CrossRefGoogle Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG. The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;7:e1000097CrossRefGoogle Scholar
NHS Digital. Hospital Admitted Patient Care Activity 2018-19. In: https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2018-19 [10 July 2020]Google Scholar
Shilo, S, Abu-Ghanem, S, Yehuda, M, Weinger, A, Fliss, DM, Abergel, A. Nasopharyngeal biopsy in adults presenting with serous otitis media: cross-sectional study. Head Neck 2018;40:1565–72CrossRefGoogle ScholarPubMed
Lee, WC, Weiner, GM, Campbell, JB. Should nasopharyngeal biopsy be mandatory in adult unilateral glue ear? J Laryngol Otol 1996;110:62–4CrossRefGoogle ScholarPubMed
Leonetti, JP. A study of persistent unilateral middle ear effusion caused by occult skull base lesions. Ear Nose Throat J 2013;92:195–200CrossRefGoogle ScholarPubMed
Ramakrishnan, K, Sparks, R, Berryhill, W. Diagnosis and treatment of otitis media. Am Fam Physician 2007;67:1650–8Google Scholar
Gates, GA, Avery, C, Prihoda, TJ, Holt, GR. Delayed onset post-tympanotomy otorrhea. Otolaryngol Head Neck Surg 1988;98:111–15CrossRefGoogle ScholarPubMed
Wen-Yuan, C, Chun-Fu, W, Chang, S-J. Ventilation tube in adults with middle-ear effusion. J Otolaryngol Neck Surg 1999;28:278–81Google Scholar
King, AD, Vlantis, AC, Bhatia, KSS, Zee, BCY, Woo, JKS, Tse, GMK et al. Primary nasopharyngeal carcinoma: diagnostic accuracy of MR imaging versus that of endoscopy and endoscopic biopsy. Radiology 2011;258:531–7CrossRefGoogle ScholarPubMed