How do you manage radiation induced serous otitis media?

In my practice, we routinely limit the cochlea to 30 Gy. Usually, this is achievable in all but the most extensive nasopharyngeal patients.

In this context, we have approximately a 10% rate of symptomatic serous otitis media. These symptoms are usually mild and do not require therapy. However, in patients with borderline hearing at baseline the additional hearing loss from serous otitis media can be profound. In such patients we do send them for evaluation by an ENT, hearing testing, and suggest myringotomy. This has been used in fewer than 1% of our patients.

We do recommend that patients who have functional hearing but are considering hearing aids wait at least one year from completion of therapy to get their hearing aids. We have had 2 pat...