Is nasopharyngoscopy necessary in adult‐onset otitis media with effusion?

BACKGROUND In an area with low risk of nasopharyngeal carcinoma, is it necessary to perform nasopharyngoscopy in adults who present with isolated otitis media with effusion? Adult-onset otitis media with effusion (AO-OME) is associated with common medical conditions such as upper respiratory tract infection (URI), sinusitis, allergic rhinitis, and adenoidal hypertrophy. It can also be a presenting feature of nasopharyngeal carcinoma (NPC). While NPC is endemic in China and Southeast Asia, it is a very rare disease (<1 per 100,000) in the United States. Despite this, it is common for American otolaryngologists to recommend nasopharyngoscopy in patients with AO-OME in order to rule out NPC. With such a rare disease, one must ask if nasopharyngoscopy is essential in adults who present with isolated AO-OME.