Current management of adults with persistent unilateral otitis media with effusion: survey of UK otolaryngologists

BACKGROUND: Persistent unilateral Otitis Media with Effusion (OME) in adults is a recognised presenting feature of nasopharyngeal carcinoma (NPC). Currently, there is no guideline-driven consensus on the optimal investigation and management for this cohort. AIM: This study aims to capture current approaches for the management of Persistent unilateral otitis media with effusion (OME) in adults among UK otolaryngologists. MATERIAL AND METHODS: newsletters in November 2024 and January 2025. Responses from consultant and non-consultant grades were analysed. RESULTS: A total of 105 clinicians (45 consultants, 60 non-consultants) responded. Initial management varied, with intranasal steroids (48.6%), auto-inflation exercises (43.8%) and expectant management (37.7%) most common. MRI was requested selectively, mainly for abnormal nasendoscopic findings. Examination under anaesthesia was reserved for suspicious cases, and malignancy in a clinically normal nasopharynx was rarely reported. CONCLUSIONS AND SIGNIFICANCE: Significant variation in practice exists, highlighting the need for an evidence-based diagnostic pathway for suspected NPC that balances early disease detection with avoidance of unnecessary investigations.