Laser myringotomy for otitis media with effusion in nasopharyngeal carcinoma patients

OBJECTIVE: To evaluate the effectiveness of laser myringotomy in otitis media with effusion (OME) in patients with nasopharyngeal carcinoma (NPC). STUDY DESIGN AND SETTING: Laser myringotomy was performed with a CO₂ laser otoscope in 53 NPC patients (68 ears) and 32 non-NPC patients (37 ears). All patients had a history of OME. RESULTS: In the NPC group, 40% of ears developed persistent perforation, 37% had recurrent OME, and 23% were free of disease. In the non-NPC group, only 3% of ears developed persistent perforation, and 43% were free of disease. Significant differences in perforation and disease-free state were evident between the 2 groups. Tumor stage was found to be a significant determining factor for clinical outcome in NPC group. CONCLUSION: Laser myringotomy for NPC group carries a significantly higher risk of persistent perforation and lower rate of cure. This procedure may be considered for early staging NPC patients with serious OME symptoms.