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[Evidence-based treatment of secretory otitis media in patients with nasopharyngeal carcinoma after radiotherapy].

OBJECTIVE
According to the principle of Evidence-Based Medicine (EBM), to analyse the cause of SOM in patients with nasopharyngeal carcinoma (NPC) after radiotherapy and to explore the effective treatment methods of SOM in patients with NPC after radiotherapy.


METHOD
One hundred and six cases (112 ears) of SOM in patients with NPC after radiotherapy were treated with comprehensive management,e. g application of general and local antibiotics,nerves nutrition medicine, blood vessel dilating drugs and hormone, reinforced clearance of nasal cavities and nasopharynx and treatment of the disease of nasal cavities and sinuses, in addition to inserting catheter into the tympanum and intratympanic application of medicine through the eustachian tube.


RESULT
Before the comprehensive treatment, all patients had hearing impairment, tinnitus and/or the feeling of ear blocked. Acoustic immittance test showed 112 ears(100%) had Type B tympanogram. After the treatment, tinnitus (ears) disappeared in 81 ears (72.32%), relieved in 25 ears (22.32%) and no effect was seen in 6 ears (5.36%). The total efficiency was 94.64. The feeling of ear blocked disappeared in 92 ears (82.14%), relieved in 18 ears (16.07%) and no effect was found in 2 ears (1.79%). The total efficiency was 98.21%. Acoustic immittance test showed 56 ears (50%) had Type A tympanogram, 42 ears had Type As (37.50%), 2 ears had Type B (1.79%) and, 12 ear had Type Cs (10.71%). The mean hearing threshold of 0.5,1,2 kHz of pure-tone was (28.5 +/- 3.0) dBHL after the treatment, which was (47.0 +/- 5.0) dBHL prior to it. No otorrhea, or permanent scar obstruction in the eustachian tube was found after the treatment.


CONCLUSION
It is very effective and practicable to treat SOM in patients with NPC after radiotherapy according to the principle of EBM and to aim directly at the cause of SOM in patients with NPC after radiotherapy. It is very significant to improve the life quality of patients with NPC after radiotherapy.