Qiang HL, Yao XL, Jiang ZF, Wang W. Laparoscopic sleeve gastrectomy combined with montelukast for obese patients with secretory otitis media. World J Gastrointest Surg 2026; 18(6): 120692 [DOI: 10.4240/wjgs.120692]
Corresponding Author of This Article
Wei Wang, Chief Physician, Department of Otorhinolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Bengbu Medical University, No. 287 Changhuai Road, Bengbu 233004, Anhui Province, China. qang2026@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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research-article
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Qiang HL, Yao XL, Jiang ZF, Wang W. Laparoscopic sleeve gastrectomy combined with montelukast for obese patients with secretory otitis media. World J Gastrointest Surg 2026; 18(6): 120692 [DOI: 10.4240/wjgs.120692]
Hua-Long Qiang, Zhen-Feng Jiang, Wei Wang, Department of Otorhinolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, Anhui Province, China
Xiang-Li Yao, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, Anhui Province, China
Author contributions: Qiang HL, Yao XL and Jiang ZF contributed to research design, data collection, data analysis, and paper writing; Wang W was responsible for research design, funding application, data analysis, reviewing and editing, communication coordination, ethical review, copyright and licensing, and follow-up.
Institutional review board statement: The research was reviewed and approved by the Bengbu Medical College, No. 2026-09.
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: No conflict of interest is associated with this work.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No other data available.
Corresponding author: Wei Wang, Chief Physician, Department of Otorhinolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Bengbu Medical University, No. 287 Changhuai Road, Bengbu 233004, Anhui Province, China. qang2026@163.com
Received: March 6, 2026 Revised: March 26, 2026 Accepted: April 14, 2026 Published online: June 27, 2026 Processing time: 108 Days and 15.5 Hours
Abstract
BACKGROUND
Obesity is associated with increased risk of otitis media with effusion (OME), potentially due to peritubal fat accumulation and chronic inflammation. Laparoscopic sleeve gastrectomy (LSG) effectively reduces weight but achieves slow early middle ear effusion resolution. Montelukast, a leukotriene receptor antagonist, possesses anti-inflammatory properties that may promote OME recovery. However, rapid weight loss may paradoxically induce patulous eustachian tube, complicating outcome interpretation. We hypothesized that combining LSG with montelukast would accelerate middle ear effusion clearance and improve eustachian tube function without compromising weight loss efficacy.
AIM
To evaluate LSG combined with montelukast for obese patients with OME regarding recovery, eustachian tube function, and weight loss.
METHODS
This retrospective cohort study enrolled 112 obese OME patients treated at a tertiary hospital between January 2020 and March 2025. Groups: Control (n = 48, LSG alone) and observation (n = 64, LSG plus oral montelukast 10 mg/day for one month). Outcomes included total weight loss, excess weight loss, middle ear effusion resolution time, air-bone gap, Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) score, 36-Item Short Form Health Survey (SF-36), and adverse events. Assessors were blinded. Inter-group comparisons used t tests and χ2 tests.
RESULTS
Baseline characteristics were comparable between groups (P > 0.05). Weight loss outcomes at 1 months and 6 months showed no significant inter-group differences (P > 0.05). Middle ear effusion clearance was significantly faster in the observation group compared to controls (28.39 ± 6.51 days vs 42.10 ± 8.32 days, P < 0.001). At one month postoperatively, the observation group demonstrated superior air-bone gap reduction (18.92 ± 4.65 dB vs 22.04 ± 4.57 dB, P = 0.001) and lower ETDQ-7 scores (2.63 ± 0.97 vs 3.75 ± 1.16, P < 0.001). SF-36 scores favored the observation group at 1 month and 3 months (P < 0.01). Adverse event rates were comparable between groups (7.81% vs 4.17%, P > 0.05).
CONCLUSION
LSG combined with montelukast significantly accelerates middle ear effusion resolution, improves auditory function and quality of life in obese OME patients, with maintained weight loss and favorable short-term safety.
Core Tip: This study first demonstrates that adding short-term montelukast after laparoscopic sleeve gastrectomy significantly accelerates middle ear effusion resolution and improves Eustachian tube function in obese patients with secretory otitis media, without affecting weight loss outcomes. This combined strategy offers a safe, effective approach for comprehensive management of this specific population.
