Abstract
Introduction: The purpose of this study was to investigate whether
patient, tumor and radiation therapy factors are associated with
development of middle ear effusion (MEE) in nasopharyngeal carcinoma
(NPC) patients.
Methods: A retrospective review of NPC patients treated between January
2000 and June 2018 at Rabin Medical Center.
Patient factors, tumor factors, radiation doses and radiation fields
were collected and outlined if needed (middle ear, eustachian tube (ET),
tensor veli palatini (TVP) and levator palatini (LVP) muscles), then
analyzed and compared between patients with MEE and those without and
between sides in patients with unilateral MEE.
Results: 73 patients were enrolled. Most were males (71.2%) with
advanced stage diseases (78%). At the time of diagnosis 14 patients
(19.2%) presented with MEE and in 18 (24.6%) patients post radiation
MEE was observed (15 ipsilateral to the tumor and 3 bilateral). Tumor
stage, histology and laterality were not associated with development of
MEE. Comparison of mean radiation field dosages including - gross target
volume (GTV), clinical target volume (CTV) and patient target volume
(PTV) showed no association with post radiation MEE. In addition, no
difference was found in the radiation doses to the middle ear, ET or the
LVP nor the TVP between ears with and without MEE.
Conclusions: Postirradiation MEE remains a common adverse effect in NPC
patients. Surprisingly, tumor stage, tumor laterality and histology were
not associated with MEE. Similar findings were observed for total
radiation doses and specific doses to the middle ear, ET and ET muscles.