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Should adults with isolated serous otitis media be undergoing routine biopsies of the post-nasal space?

Published online by Cambridge University Press:  10 September 2020

H A Cunniffe ,
A K Gona  and
J S Phillips
H A Cunniffe
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
A K Gona*
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
J S Phillips
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
*
Author for correspondence: Mr Ajay Kumar Gona, Department of Otolaryngology, Norfolk and Norwich University Hospital, Colney Lane, NorwichNR4 7UY, UK E-mail: ajaygona@gmail.com Fax: +44 (0)1603 287288
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Abstract

Background

Serous otitis media is a recognised presentation of Eustachian tube dysfunction secondary to post-nasal space pathology. Post-nasal space biopsies are commonly taken in patients with isolated serous otitis media, despite normal nasendoscopy findings, without robust evidence for doing so. This study examined cases of unilateral serous otitis media with effusion in adults. It is the largest known retrospective study to investigate whether post-nasal space biopsies are indicated in non-endemic regions.

Methods

A retrospective analysis was performed of 119 patients who underwent post-nasal space biopsy because of isolated serous otitis media, in a tertiary referral centre, from 2007 to 2017. Endoscopic examination and final histological report findings were reviewed.

Results

Of the 119 patients identified, 6 (5.0 per cent) were found to have abnormal histology. In all six cases, suspicious clinical findings had been noted on nasendoscopic examination prior to biopsy.

Conclusion

Suspicious findings pre-operatively predict sinister pathology. Biopsies are not recommended in cases of adult serous otitis media with normal nasendoscopy findings if no other risk factors exist. A UK-wide retrospective study or prospective study over the next 10 years will help provide the evidence necessary to support this guidance.

Keywords

OtolaryngologyNasopharyngeal NeoplasmsNasopharynxOtitis Media With EffusionAdultHumansRetrospective StudiesEustachian TubeEndoscopyBiopsy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 9 , September 2020 , pp. 811 - 813
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Mr A K Gona takes responsibility for the integrity of the content of the paper

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