a Department of Otorhinolaryngology and Maxillofacial Surgery , Zealand University Hospital , Køge , Denmark.
b Department of Otorhinolaryngology Head & Neck Surgery and Audiology , Copenhagen University Hospital , Copenhagen , Denmark.
Acta Oncol. 2018 Aug;57(8):1011-1016. doi: 10.1080/0284186X.2018.1468085. Epub 2018 Apr 26.
Otitis media (OM) and associated hearing problems may be side effects to radiotherapy of the head and neck region and affect patient quality of life. The condition is associated with the tumor location.
To perform a systematic review concerning the present knowledge of the risk of OM after radiotherapy of the head and neck.
A comprehensive search of PubMed and Embase was carried out between 1 October 2015 and 6 February 2017. The search strategy followed the PRISMA guideline for systematic reviews.
Of 597 articles 11 fulfilled the inclusion criteria. Seven were retrospective and four prospective. There were no randomized controlled trials. Eight studies concerned nasopharyngeal cancer. One study concerned cancer of the parotid gland and two studies concerned other locations of head and neck cancer. Meta-analysis could not be done due to heterogeneity between the studies. The incidence of OM varied considerably (range 8-29%).
The incidence of OM is high after radiotherapy of cancer of the upper head and neck area and the Eustachian tube (ET) irradiation dosage seems associated with development of OM, but the literature is poor. Research is needed to designate patients at risk of developing OM after radiotherapy. Preferably through analysis of dosage relationships between the ET and middle ear, and development of OM. Reporting of OM should be per ear and follow standardized protocols of middle ear assessment before and after radiotherapy. Furthermore, there is a need to find new ways to prevent and treat radiation-induced OME, preferably through randomized controlled trials.
中耳炎（OM）及相关听力问题可能是头颈部放疗的副作用，并影响患者的生活质量。这种情况与肿瘤的位置有关。
对头颈部放疗后 OM 风险的现有知识进行系统评价。
于 2015 年 10 月 1 日至 2017 年 2 月 6 日，对 PubMed 和 Embase 进行全面检索。检索策略遵循 PRISMA 系统评价指南。
共检索到 597 篇文章，有 11 篇符合纳入标准。其中 7 篇为回顾性研究，4 篇为前瞻性研究。没有随机对照试验。8 项研究涉及鼻咽癌，1 项研究涉及腮腺癌，2 项研究涉及头颈部其他部位的癌症。由于研究之间存在异质性，因此无法进行荟萃分析。OM 的发生率差异很大（范围 8%-29%）。
上头部和颈部区域癌症以及咽鼓管（ET）放疗后 OM 的发生率很高，而 ET 照射剂量似乎与 OM 的发生有关，但文献质量较差。需要研究指定放疗后发生 OM 的高危患者。最好通过分析 ET 和中耳之间的剂量关系，以及 OM 的发生来进行研究。OM 的报告应该是每只耳朵，并且应遵循放疗前后中耳评估的标准化方案。此外，需要找到预防和治疗放射性渗出性中耳炎的新方法，最好通过随机对照试验。
