Long‐term sensorineural hearing deficit following radiotherapy in patients suffering from nasopharyngeal carcinoma: A prospective study

Abstract

Background. This was a prospective study to evaluate the effect of radical external irradiation on inner ear function after treatment of nasopharyngeal carcinoma.Methods. Pure tone audiograms were performed at regular intervals before, after, and up to 4.5 years following completion of radiotherapy.Results. Two hundred ninety-four patients (526 ears) were included. Within 3 months after radiotherapy, deterioration of bone conduction threshold at 4 kHz and pure tone average (average of 0.5 kHz, 1 kHz, and 2 kHz) were noted in 164 ears (31%) and 75 ears (14%), respectively. Patients older than 50 years and ears with threshold below 60 dB at 4 kHz before radiotherapy were significant factors (p < 0.01 and p < 0.001) associated with a 4 kHz loss. In 40% of these ears, recovery was evident at 2 years. With follow-up for 4.5 years, the probability of significant threshold deterioration increased with time.Conclusion. Sensorineural hearing loss started soon after radiotherapy. Early changes could be reversible while the probability of persistent hearing loss continued to increase. o n t r a c t g r a n t n u m b e r s : 1 0 2 0 0 3 8 9 . 0 5 0 7 8 . 2 1 7 0 0 .

Short-term cohort study on sensorineural hearing changes in head and neck radiotherapy

“…The risk of hearing loss is also increased when radiation is paired with platinum-based chemotherapy. Another factor that may affect hearing loss is the individual baseline hearing threshold, by which our finding showed that the patients with a history of otitis media may induce earlier radiation-induced SNHL which is in agreement with the finding by Ho et al [12]. It was also found that the risk of SNHL increases with the age during the time of radiation treatment which is also confirmed by other researchers [13][14][15][16].…”

“…We saw in the chemoradiation group that hearing loss tends to occur first only at high frequencies; this is also confirmed by other reports (10)(11)(12)(13)(14). However, at later follow-ups, the severity of hearing loss was increased due to chemoradiation.…”

A retrospective study of salvage surgery for recurrent nasopharyngeal carcinoma

“…In recent years, the reported 5-year survival rate of NPC by radiotherapy has ranged from 59 to 76.1% [3]. Complications of radiotherapy are well documented, and include xerostomia, dysphagia, hearing loss, and impaired cognitive function [4][5][6][7]. When there is local relapse of NPC, re-irradiation treatment is inevitably associated with serious complications and decreased quality of life, and the treatment result is not satisfactory [8][9][10].…”

Prospective study on the dose distribution to the acoustic structures during postoperative 3D conformal radiotherapy for parotid tumors

“…Several patient-, tumor-, and treatment-related factors have been reported to be associated with the risk of hearing impairment after irradiation including total radiotherapy dose [2,6,23], fractionation [2], site of the tumor (nasopharyngeal and parotid tumors associated with the higher risk) [22], involvement of the upper cervical lymph nodes [9], stereotactic radiotherapy in the patient affected by neurofibromatisis 2 [9], age greater than 50 years [2,12,23], hearing deficit present before radiotherapy [12,23], and use of cisplatin-containing chemotherapy [2,13]. Lower ototoxicity in the parotid cancer patients when compared to the squamous cell head and neck cancer cases observed in some series may be explained by no use of chemotherapy in the postoperative approach in parotid tumors, lower mean patient age, lower radiotherapy dose (due to adjuvant irradiation), unilateral radiotherapy, and particular (superficial) tumor location.…”

“…In fact, up to 60% of the nasopharyngeal cancer patients treated with radiotherapy suffer from acute, transitory hearing deterioration during and within 3 months after irradiation [2,3,12,17]. Up to 30% of patients develop chronic injury.…”