Middle Ear Bacterial Colonization and Recurrence of Radiation-Induced OME: A Prospective Study.

Area of Science:

• Otolaryngology
• Infectious Diseases
• Oncology

Background:

• Otitis media with effusion (OME) is a common complication following radiotherapy for nasopharyngeal carcinoma (NPC).
• Understanding the bacteriological profile of radiation-induced OME (RI-OME) is crucial for managing recurrence.
• The association between middle ear bacterial colonization and RI-OME recurrence risk requires further investigation.

Purpose of the Study:

• To characterize the bacteriology of OME in NPC patients post-radiotherapy.
• To determine if bacterial colonization in middle ear effusion (MEE) increases the risk of early RI-OME recurrence.

Main Methods:

• Prospective multicenter cohort study of patients with OME undergoing tympanocentesis.
• Middle ear effusion (MEE) samples were cultured for bacterial analysis.
• Patients with RI-OME were followed for 24 weeks to assess recurrence patterns.

Main Results:

• RI-OME patients exhibited significantly higher MEE bacterial culture positivity (4.843-fold risk) compared to non-radiation-induced OME (NRI-OME) patients.
• MEE cultures in RI-OME revealed increased opportunistic pathogens and drug-resistant bacteria.
• Mucoid effusion, male sex, and bacterial colonization were associated with early RI-OME recurrence (≤4 weeks), but not independent long-term predictors.

Conclusions:

• RI-OME is associated with higher rates of bacterial middle ear infection.
• While bacterial colonization influences early RI-OME recurrence, its prognostic value for 24-week recurrence is limited.
• Further studies are needed to evaluate the efficacy of targeted antibacterial therapy in reducing RI-OME recurrence.