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Relationship between Eustachian tube dysfunction and otitis media with effusion in radiotherapy patients

  • K Akazawa (a1), H Doi (a2), S Ohta (a1), T Terada (a1), M Fujiwara (a2), N Uwa (a1), M Tanooka (a3) and M Sakagami (a1)...



This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion.


The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose–volume histogram parameters.


Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes.


The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.


Corresponding author

Address for correspondence: Dr Kazuyuki Akazawa, Department of Otolaryngology – Head and Neck Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501, Japan Fax: +81 798 41 8976 E-mail:


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Presented as a poster at the 120th Annual Meeting of the American Academy of Otolaryngology – Head and Neck Surgery, 20 September 2016, San Diego, California, USA.



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