Evaluating Adverse Outcomes After Myringotomy or Tube Placement in Head and Neck Cancer.

Abstract

Objective: Evaluate rates of adverse outcomes among patients with a history of head and neck cancer undergoing myringotomy with or without tube placement for middle ear effusion.

Study design: Retrospective chart review.

Setting: Academic medical center.

Methods: Retrospective chart review was performed on patients undergoing myringotomy with or without tube placement for middle ear effusion between 2018 and 2022. Data reviewed included demographics, cancer history, audiometry, and clinical course.

Results: In total, 578 patients (736 ears) had a mean follow-up of 36.6 months: 84 (14.53%) were in the cancer cohort. On average, cancer patients were older (62.6 vs 59.3 years, P < .05) but had similar rates of overall adverse outcomes (44.05% vs 44.13%, P = 1.0). Rates of persistent perforation were higher among cancer patients (14.29% vs 2.43%, P < .001); there was no significant difference in rates of recurrent effusion (5.95% vs 4.66%; P = .81). Postpropensity score matching, perforation rates reached statistical significance (14.29% vs 1.22%, P < .01). There was no difference in rate of adverse events for overall events (44.05% vs 47.56%, P = .77) or recurrent effusion (5.95% vs 1.22%, P = .22).

Conclusion: Patients with a history of head and neck cancer or radiation have a three-to-five-fold risk of persistent tympanic membrane perforation after myringotomy with or without tube placement and a higher rate of recurrent effusion that is not significant. In multivariate analysis, perforation risk was revealed to be multifactorial.