Challenges of Hearing Rehabilitation after Radiation and Chemotherapy

Nader, Marc‐Elie; Gidley, Paul W.

doi:10.1055/s-0039-1677865

Cited by 19 publications

(24 citation statements)

References 102 publications

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“…These include sequalae such as permanent hearing loss that can impair functional status, workplace productivity and overall quality of life. Hearing aids are often the initial intervention for hearing loss in the setting of ototoxicity and primarily allow for sound amplification [30,31]. Difficulties with voice discrimination, particularly in noisy environments is common amongst hearing aid users as normal hearing cannot be restored [31].…”

Section: Discussionmentioning

confidence: 99%

“…Difficulties with voice discrimination, particularly in noisy environments is common amongst hearing aid users as normal hearing cannot be restored [31]. Other limitations of hearing aids include affordability and the stigma associated with their use [30]. It should also be acknowledged that audiologic rehabilitation may not the predominant priority for patients with an oncologic history given required follow-up for recurrence surveillance and additional sequela.…”

Section: Discussionmentioning

confidence: 99%

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Insight into the current practice of ototoxicity monitoring during cisplatin therapy

Santucci

Garber

Ivory

et al. 2021

J of Otolaryngol - Head & Neck Surg

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Background The aim of this study is to evaluate the current state of ototoxicity monitoring for patients receiving cisplatin chemotherapy in an academic medical center with particular attention to how closely monitoring adheres to national ototoxicity guidelines. Methods Case series including retrospective medical records review of patients (age > 18) treated with cisplatin at University of California Davis Medical Center between January 2014 and August 2017. Patient and ototoxicity related variables were analyzed. Patients that underwent a transfer of care during treatment and with less than 3 months of follow-up were excluded. Results Three hundred seventy-nine patients met study criteria, of which 104 (27.4%) had a prior history of hearing loss. Prior to treatment, 196 (51.7%) patients were counseled regarding the ototoxic nature of cisplatin and 92 (24.3%) patients had a pretreatment audiogram. During treatment, 91 (24%) patients had documented otologic complaints. Only 17 patients (4.5%) patients had an audiogram ordered during their cisplatin treatment period. 130 (34.3%) patients had otologic complaints following cisplatin treatment. Audiograms were ordered for 20 (7.8%), 13 (5.1%), and 16 (6.2%) patients at 1-month, 3-month, and 6-month follow-ups, respectively. No patients in the study cohort received baseline, treatment, and post-treatment audiograms as recommended by national ototoxicity monitoring protocols. Patients with Head and Neck Cancer (HNC) represented the largest subgroup that received cisplatin (n = 122, 32.2%) and demonstrated higher rates of ototoxicity counseling (n = 103, 84.4%) and pretreatment audiograms (n = 70, 57.4%) compared to the non HNC group (n = 36, 36.2%, P < 0.0001 and n = 22, 8.5%, P < 0.0001). Conclusions There is poor adherence to national ototoxicity monitoring guidelines at a large academic medical center. This is a missed opportunity for intervention and aural rehabilitation. Improved education and collaboration between otolaryngology, audiology, and medical oncology is needed to develop and promote an effective ototoxicity-monitoring program. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Insight into the current practice of ototoxicity monitoring during cisplatin therapy

Santucci

Garber

Ivory

et al. 2021

J of Otolaryngol - Head & Neck Surg

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“…Radiation to the ears may result in serous otitis (otitis with effusion) [38]. It is associated with fluid collection in the middle ear and temporary reduced hearing.…”

Section: Damage To the Ear (Ototoxicity) And Hearing Lossmentioning

confidence: 99%

Late side effects of radiation treatment for head and neck cancer

Brook

2020

Radiat Oncol J

141

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Radiation therapy (RT) is often used to treat head and neck cancer (HNC) [1]. RT can damage blood vessels that nourish muscles, nerves, and bones resulting in a progressive "radiation fibrosis syndrome", which causes a variety of complications [2]. The likelihood and severity of complications depends on a number of factors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. The side effects of RT for HNC are divided into early (acute) and long-term (chronic) effects [3]. Early side effects occur during the course of therapy and during the immediate post therapy period (approximately 2-3 weeks after the completion of a course of RT). Late effects can manifest any time thereafter, from weeks to years later [4]. Patients are usually most bothered by the early effects of RT, although these will generally resolve over time. Knowledge of the ra-Patients undergoing radiation therapy for head and neck cancer (HNC) experience significant early and long-term side effects. The likelihood and severity of complications depends on a number of factors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. Late side effects include: permanent loss of saliva; osteoradionecrosis; radiation recall myositis, pharyngoesophageal stenosis; dental caries; oral cavity necrosis; fibrosis; impaired wound healing; skin changes and skin cancer; lymphedema; hypothyroidism, hyperparathyroidism, lightheadedness, dizziness and headaches; secondary cancer; and eye, ear, neurological and neck structures damage. Patients who undergo radiotherapy for nasopharyngeal carcinoma tend to suffer from chronic sinusitis. These side effects present difficult challenges to the patients and their caregivers and require lifelong strategies to alleviate their deleterious effect on basic life functions and on the quality of life. This review presents these side effects and their management.

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“…In our patient, compression of the quadrigeminal plate may therefore also be implicated in his poor hearing and word recognition. In cancer patients with bilateral profound hearing loss, such as the present case, cochlear implantation remains a viable auditory rehabilitation option even in patients requiring chemotherapy or radiation therapy [9].…”

Section: A C C E P T E Dmentioning

confidence: 80%

Pearls & Oy-sters: Primary Pineal Melanoma With Leptomeningeal Carcinomatosis

Aaroe¹,

Al‐Zubidi²,

Nader³

et al. 2021

Neurology

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Pineal masses commonly present with Parinaud syndrome, a triad consisting of upgaze restriction, convergence-retraction nystagmus, and pupillary light-near dissociation from compression of the quadrigeminal plate. cThe differential diagnosis for pineal region tumors includes germ cell tumors, pineal parenchymal tumors, glioma, atypical teratoid rhabdoid tumor, and metastatic disease. While exceedingly uncommon, primary pineal melanoma is also a known histopathologic entity that is suspected to arise from melanocytes in the pia mater of the pineal gland. c Primary pineal melanoma is often treated with surgical resection, radiation, and either chemotherapy or immunotherapy. Some patients have received targeted therapy (such as vemurafenib in patients with BRAF V600E mutation) with varying degrees of success. Oy-sters cCSF sampling can assist in the diagnosis of pineal tumor, specifically to test for germ cell tumor markers (α-fetoprotein, β-human chorionic gonadotropin, placental alkaline phosphatase), systemic tumor markers such as carcinoembryonic antigen, cell-free DNA, or malignant cells on cytopathology. c Pineal tumors can result in obstructive hydrocephalus; therefore, lumbar puncture is not always a feasible option due to the risk of herniation. In patients with melanoma of the CNS, a careful survey consisting of systemic imaging and total body skin examination are warranted to exclude a separate primary melanoma lesion. cThe differential diagnosis for rapidly progressive bilateral sensorineural hearing loss includes meningitis, superficial siderosis, ototoxicity, and leptomeningeal disease. Difficulty in speech comprehension in excess of pure tone audiometry may suggest involvement or compression of the inferior colliculus.A 62-year-old man presented with 5 months of rapidly progressive bilateral hearing loss. He was evaluated by a local provider who ascribed his symptoms to normal aging and prescribed hearing aids. The patient then developed intermittent binocular diplopia. He denied personal or family history of malignancy. Neuro-ophthalmologic examination revealed light-near dissociation with minimal retraction nystagmus on upward gaze consistent with Parinaud syndrome (eFigure 1, data available from Dryad; doi.org/10.5061/dryad.cvdncjt2w). No papilledema was seen. Audiometry showed moderate to severe high-frequency bilateral sensorineural hearing loss and absent word recognition skills. The remainder of his neurologic examination was unremarkable.Contrast-enhanced MRI of the brain demonstrated an intrinsically T1 hyperintense contrastenhancing mass in the pineal region with extension into the tectum, midbrain, and bilateral thalami, and protruding into the third ventricle, resulting in ventriculomegaly (Figure 1). The

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Challenges of Hearing Rehabilitation after Radiation and Chemotherapy

Cited by 19 publications

References 102 publications

Insight into the current practice of ototoxicity monitoring during cisplatin therapy

Insight into the current practice of ototoxicity monitoring during cisplatin therapy

Late side effects of radiation treatment for head and neck cancer

Pearls & Oy-sters: Primary Pineal Melanoma With Leptomeningeal Carcinomatosis

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