Department of Otolaryngology - Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Head Neck. 2018 Jul;40(7):1565-1572. doi: 10.1002/hed.25135. Epub 2018 Mar 14.
The purpose of this study was to investigate the association between isolated serous otitis media (SOM) and/or conductive hearing loss (CHL) and nasopharyngeal carcinoma (NPC) in a low-to-intermediate endemic area.
Medical records of all adult patients (≥17 years) with SOM/CHL who underwent endoscopic-guided nasopharyngeal biopsy to exclude NPC during a 10-year period were reviewed. Statistical analyses were conducted to identify significant predictors for NPC.
A total of 195 patients were included (121/195; 62.1% men), among whom 169 (86.7%) presented with isolated SOM/CHL. Overall, 12 patients were diagnosed with NPC (12/195; 6.2%), however, only 1 patient (1/169; 0.6%) had isolated SOM/CHL. Coexisting clinical manifestations and suspicious nasopharyngeal findings on fiber-optic nasopharyngoscopy were found to be significant predictors for NPC on univariate and multivariate analyses (P < .05).
Patients with isolated SOM/CHL and without coexisting clinical manifestations or suspicious findings on nasopharyngoscopy may avoid a routine nasopharyngeal biopsy.
本研究旨在探讨中低度流行地区孤立性浆液性中耳炎（SOM）和/或传导性听力损失（CHL）与鼻咽癌（NPC）之间的关联。
回顾性分析了 10 年间因 SOM/CHL 而行内镜引导下鼻咽活检排除 NPC 的所有成年患者（≥17 岁）的病历。对统计学分析以确定 NPC 的显著预测因素。
共纳入 195 例患者（121/195；62.1%为男性），其中 169 例（86.7%）为单纯 SOM/CHL。总体而言，12 例患者被诊断为 NPC（12/195；6.2%），但仅有 1 例（1/169；0.6%）为单纯 SOM/CHL。单因素和多因素分析显示，同时存在临床症状和纤维鼻咽镜下可疑鼻咽部表现是 NPC 的显著预测因素（P<.05）。
对于无同时存在的临床症状或鼻咽镜下可疑表现的单纯 SOM/CHL 患者，可能无需进行常规鼻咽活检。
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