Otorrhea after grommet insertion for middle ear effusion in patients with nasopharyngeal carcinoma

Purpose: To document the incidence of complications after myringotomy and g rommet insertion rn patients with nasopharyngeal carcinoma. The focus is on the incidence of otorrhea and perforation. The possible risk factors for t hese conditions and treatment response were studied. Materials and Methods: We reviewed the records on 206 ears of 163 patients who suffered from nasopharyngeal carcinoma and underwent myringotomy and gr ommet insertion in a 7-year period. The follow-up period ranged from 4 week s to 78 months (median, 9 months). Results: The overall incidence of otorrhea in these ears was 38%. Patients with nasopharyngeal carcinoma (NPC) had a significantly high incidence of p ostoperative discharge (chi(2) test, P<.0001) compared with other patients who underwent myringotomy and grommet insertion. The mean interval between myringotomy and otorrhea was 19.8 weeks. Forty-seven per cent of the ears w ith a discharge developed otorrhea within 1 month. In 42%, the otorrhea res ponded to treatment and the ears became dry. After extrusion of the grommet , 29% of those ears with otorrhea ended with an eardrum perforation, and 24 % of the ears showed recurrent effusion. Conclusions: For patients with NPC who underwent myringotomy, there was a s ignificant risk of otorrhea (49%) and persistent perforation (29%), and the se complications were difficult to manage. We conclude that myringotomy and grommet insertion should not be routinely offered to NPC patients with mid dle ear effusion. Copyright (C) 1999 by W.B. Saunders Company.