Association of hearing loss and tinnitus symptoms with health‐related quality of life among long‐term oropharyngeal cancer survivors

Abstract

Background This study investigated the association of hearing loss and tinnitus with overall health‐related quality of life (HRQoL) among long‐term oropharyngeal cancer (OPC) survivors. Methods This study included OPC survivors treated between 2000 and 2013 and surveyed from September 2015 to July 2016. Hearing loss and tinnitus were measured by asking survivors to rate their “difficulty with hearing loss and/or ringing in the ears” from 0 (not present) to 10 (as bad as you can imagine). Hearing loss and tinnitus scores were categorized as follows: 0 for none, 1–4 for mild, and 5–10 for moderate to severe. The primary outcome was the mean score of MD nderson Symptom Inventory Head & Neck module interference component as a HRQoL surrogate dichotomized as follows: 0 to 4 for none to mild and 5 to 10 for moderate to severe interference. Results Among 880 OPC survivors, 35.6% (314), reported none, 39.3% (347) reported mild, and 25.1% (221) reported moderate to severe hearing loss and tinnitus. On multivariable analysis, mild (OR, 5.83; 95% CI; 1.48–22.88; p = 0.012) and moderate (OR, 30.01; 95% CI; 7.96–113.10; p < 0.001) hearing loss and tinnitus were associated with higher odds of reporting moderate to severe symptom interference scores in comparison to no hearing loss and tinnitus. This association of hearing dysfunction was consistent with all domains of HRQoL. Conclusions Our findings provide preliminary evidence to support the need for continued audiological evaluations and surveillance to detect hearing dysfunction, to allow for early management and to alleviate the long‐term impact on QoL.

The long-term impacts of hearing loss, tinnitus and poor balance on the quality of life of people living with and beyond cancer after platinum-based chemotherapy: a literature review

“…Parents were concerned over their child’s mental health, with reports that they felt miserable, frustrated and anxious. They also had reduced independence and a lessened ability to interact and communicate with peers and family—a pattern we have seen before in adults too [ 26 , 29 , 31 , 33 ]. These children needed more support during social interactions, which limits the extent to which they can navigate their environment, develop independence and socialise with peers without their parents, both in and out of school.…”

“…These barriers to communication have been shown to effect relationships with partners and family members. Compared to those without tinnitus and hearing loss, those with mild or moderate-severe hearing loss and tinnitus had greater odds of self-reported interference in relations with others [ 31 ]. This demonstrates that the degree of ototoxicity does not even have to be severe to cause a negative impact.…”

“…Compared to adults LWBC who have not developed ototoxicity, those with moderate to severe tinnitus and hearing loss report greater interference in general activity, walking and working. In fact, they also report greater interference in the enjoyment of life [ 31 ]. As mentioned previously, the extent of hearing loss and tinnitus does not need to be severe to have a negative impact.…”

“…Cross-sectional research has demonstrated that adults treated for oropharyngeal cancer who have acquired mild hearing loss and tinnitus are six times more likely to report moderate to severe functional and psychosocial interference than those without hearing loss and tinnitus. This increases to 30 times if the hearing loss and tinnitus are severe [ 31 ]. Sleep disturbances, fatigue and lower morning and evening energy have also been associated with ototoxicity in both cross-sectional and qualitative research [ 29 , 44 , 55 ].…”

“…On one hand, some adults are extremely and adversely affected. Cross-sectional research has demonstrated greater interference in mood in adults LWBC with hearing loss and tinnitus compared to those without [ 31 ]. Higher levels of stress have also been reported in those with ototoxicity, as well as distress related to imbalance [ 44 ] and tinnitus [ 32 ].…”