Otitis media with effusion in adults during the SARS-CoV-2 epidemic

Abstract

Objectives The purpose of this study was to investigate the fluctuations in the prevalence of individuals diagnosed with otitis media with effusion (OME) during the SARS-CoV-2 pandemic, while also evaluating the persistence of SARS-CoV-2 in middle ear effusion (MEE) and assessing the effectiveness of tympanocentesis as a treatment modality for OME in this specific period. Methods The total number of outpatients and patients diagnosed with OME in our department was recorded for January 2022 and January 2023. Thirty patients (aged 15–86 years) were categorized into two groups: group A (n = 12), who developed OME during their SARS-CoV-2 infection and group B (n = 18), who experienced OME after the resolution of SARS-CoV-2 infection. All patients underwent otoendoscopic tympanocentesis (without a ventilation tube), where MEE and nasopharyngeal secretions were simultaneously collected for SARS-CoV-2 detection by polymerase chain reaction. The time interval from SARS-CoV-2 infection to tympanocentesis, results of SARS-CoV-2 detection, preoperative and postoperative average hearing threshold, and Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores were documented. Results The proportion of outpatients with OME in January 2023 was higher than that in January 2022. There were five patients who had positive test results for SARS-CoV-2 on MEE after tympanocentesis. These 5 patients underwent tympanocentesis at a mean of 28 ± 7.28 days following confirmation of SARS-CoV-2 infection. The ETDQ-7 scores of group A exhibited a reduction from 21.85 ± 4.8 to 10.00 ± 4.07 following tympanocentesis, while the ETDQ-7 scores of group B also demonstrated a decrease from 21.22 ± 4.65 to 10.11 ± 3.68 after undergoing tympanocentesis. The tympanocentesis was effective in both groups. Conclusions The study confirmed that the proportion of outpatients with OME in the Clinics of Otolaryngology during the SARS-CoV-2 epidemic increased significantly. SARS-CoV-2 RNA was detectable in MEE of COVID-19-related OME patients. Tympanocentesis was therapeutic for OME during SARS-CoV-2 infection, which facilitated viral clearance in MEE.

Clinical manifestations and outcomes of otitis media with effusion in adult patients following Omicron infection in China

“…Liang et al [ 23 ] proposed that administering steroids via intratympanic injection is an optimal approach for minimizing systemic adverse effects. Zhang et al [ 31 ] reported that tympanocentesis has a beneficial therapeutic effect for these patients, as it aids in the clearance of SARS-CoV-2 in the MEE. It is essential for the medical process to consider the treatment effectiveness and its environmental impact, particularly in the context of the COVID-19 pandemic [ 32 ].…”

“…First, upper respiratory tract viral infections trigger an inflammatory reaction in the nasopharynx, which might ultimately result in eustachian tube blockage. Zhang et al [ 31 ] observed that all patients with OME caused by COVID-19 exhibited Eustachian tube dysfunction and considered it a fundamental basis and pathway for OME development. Second, the Omicron variation of SARS-CoV-2 generates a higher and more sustained viral load in the nasopharynx than the previously predominant Delta version [ 33 ].…”