PDF(Pubmed)
Abstract：
Head and neck cancers, including nasopharyngeal carcinoma (NPC), are relatively common in Saudi Arabia. Radiotherapy is a standard treatment for NPC, but it can lead to side effects, including post-radiation otitis media with effusion (OME). Managing post-radiotherapy OME remains a topic of debate, with various interventions proposed. This study aims to review the efficacy of different methods to manage post-radiotherapy OME in NPC. This includes tympanostomy tube insertion, frequent myringotomies, and observation. A systematic review was carried out for articles published between 1975 and 2023 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Excluded from the analysis were articles that involved patients undergoing surgical treatment for nasopharyngeal cancer, studies that focused on patients with other head and neck cancers who developed OME after radiotherapy, research investigating the effectiveness of surgical procedures unrelated to tympanostomy tube insertion, studies written in non-English language, and case reports, reviews, or conference letters. A total of 450 studies were screened, of which six studies were included in the review, yielding 328 patients. The mean age ranged between 46 and 52 years. Follow-up varied from six months to 11 years. The intervention in all studies was tympanostomy tube insertion, and the controls were myringotomy, observation, or tympanic membrane fenestration with cauterization. The use of recurrent myringotomies for the treatment of OME in patients with NP post-radiotherapy is associated with improved chances for the resolution of effusion and decreased risk of complications when compared to tympanostomy tube insertion. Hence, we recommend following a step-wise approach when dealing with this group of patients, offering grommets for patients with persistent effusion or those who cannot tolerate frequent procedures.
摘要：
头颈癌,包括鼻咽癌（NPC），在沙特阿拉伯比较常见。放射治疗是NPC的标准治疗方法,但它会导致副作用，包括放射后中耳炎伴积液（OME）。管理放疗后的OME仍然是一个争论的话题，提出了各种干预措施。本研究旨在回顾鼻咽癌放疗后OME的不同管理方法的疗效。这包括鼓膜置管,频繁的肌切开术,和观察。根据系统审查和荟萃分析（PRISMA）指南的首选报告项目，对1975年至2023年之间发表的文章进行了系统审查。从分析中排除了涉及接受鼻咽癌手术治疗的患者的文章，重点研究其他头颈部癌症患者在放疗后发生OME，研究与鼓膜置管无关的外科手术的有效性，用非英语语言写的研究，和病例报告，reviews,或会议信件。总共筛选了450项研究，其中六项研究被纳入审查，产生328名患者。平均年龄在46至52岁之间。随访时间从6个月到11年不等。所有研究的干预措施都是鼓膜置管，对照组是鼓膜切开术，观察,或鼓膜开窗与烧灼。与鼓膜置管术相比，在NP放疗后患者中使用复发性鼓膜切开术治疗OME与改善积液消退的机会和降低并发症的风险有关。因此，我们建议在处理这组患者时采取循序渐进的方法，为持续性积液患者或不能耐受频繁手术的患者提供索环。
