{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:48:10Z","timestamp":1786470490837,"version":"build-2736575974"},"reference-count":75,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Nasopharyngeal carcinoma carries a significant health burden in Asia, with incidence reaching up to 25 per 100,000. Post\u2010radiotherapy otitis media with effusion develops in 32.4% of NPC patients, representing the most frequent otologic toxicity. This meta\u2010analysis provides the first quantitative synthesis of post\u2010radiotherapy OME risk in NPC patients with technique\u2010specific estimates for clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Embase, and Cochrane Library were searched from inception through April 23, 2025, using controlled vocabulary terms related to nasopharyngeal carcinoma, radiotherapy modalities, and otitis media with effusion. Additional articles were identified through reference screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Observational studies published as full\u2010length English articles reporting OME development in NPC patients following radiotherapy were included. The Newcastle\u2010Ottawa Scale assessed bias. Random\u2010effects modeling with risk difference (RD) as the effect measure was used, with Hartung\u2010Knapp adjustment applied to mitigate small\u2010study effects. Findings were reported per PRISMA guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight studies comprising 10 cohorts (582 patients, mean age 50.4\u2009years) were included. Among all NPC patients undergoing radiotherapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009962), the overall RD was 0.08 (95% CI: 0.01\u20130.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0078). For OME\u2010na\u00efve patients, the relative risk of acquiring OME post\u2010RT was 0.18 (95% CI: \u22120.06 to 0.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Technique\u2010specific analysis revealed conventional two\u2010dimensional radiotherapy (2D\u2010RT) risk of 0.18 (95% CI: \u22120.24 to 0.60), three\u2010dimensional conformal radiotherapy (3D\u2010CRT) risk of 0.18 (95% CI: \u22120.13 to 0.49), and intensity\u2010modulated radiotherapy (IMRT) risk of 0.19 (95% CI: 0.01\u20130.27). Chemotherapy exposure and NPC stage showed no significant association.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radiotherapy significantly increases OME risk in NPC patients with marked technique\u2010specific variation, enabling personalized counseling and evidence\u2010based surveillance protocol development.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                    <\/jats:p>\n                    <jats:p>CRD420251012963<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70535","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T04:15:31Z","timestamp":1775103331000},"page":"3718-3731","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Radiotherapy\u2010Induced Otitis Media With Effusion in Nasopharyngeal Carcinoma: A Meta\u2010Analysis"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4780-3592","authenticated-orcid":false,"given":"Nevin Yi Meng","family":"Chua","sequence":"first","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0484-5617","authenticated-orcid":false,"given":"Yong Hoe","family":"Chan","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0464-0542","authenticated-orcid":false,"given":"Woei Shyang","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0909-2963","authenticated-orcid":false,"given":"De Yun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.5732\/cjc.010.10377"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.96802"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102024\u2010091087"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/bjbs.2025.15902"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0219611"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.08.006"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27303"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23215"},{"key":"e_1_2_9_10_1","volume-title":"Otitis Media With Effusion","author":"Searight F. 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