Management Options for Patients With Nasopharyngeal Carcinoma Undergoing Cochlear Implantation

Lee, Chee-Yee; Lin, Wei-Chieh; Lin, Chung-Ching; Hsu, Chuan‐Jen; Wu, Hung‐Pin

doi:10.1177/0145561320947274

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…Radiation-induced complications of the temporal bone were reported in nine studies (Table 1) (13,19,(21)(22)(23)(24)(26)(27)(28). These included chronic otitis media (COM; n = 18), eustachian tube dysfunction (n = 10), osteoradionecrosis (n = 7), and otitis media with effusion (n = 4).…”

Section: Complicationsmentioning

confidence: 99%

Cochlear Implantation in Radiation-Induced Hearing Loss: A Systematic Review

Alahmadi

Abdelsamad²,

Al-Zuraiqi

et al. 2023

Otol Neurotol

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Objective Cochlear implantation (CI) has been reported as a treatment modality for radiation-induced sensorineural hearing loss (SNHL). However, its efficacy is based on individual reports with no cumulative supporting evidence. Therefore, we conducted the current systematic review to provide cumulative evidence regarding the feasibility and safety of CI in this context. Databases Reviewed An online bibliographic search was conducted in PubMed, ProQuest, Scopus, Google Scholar, and Web of Science using MeSH-based terms. Methods A systematic review was conducted to retrieve both observational and interventional studies that reported the outcomes of CI for patients suffering from radiation-induced SNHL. Results We included 12 studies that recruited 88 patients who underwent CI because of radiation-induced SNHL. All included studies reported satisfactory hearing/speech perception outcomes. No serious complications were reported, whereas some manageable adverse events were reported, such as paroxysmal facial spams (n = 1), postauricular wound dehiscence with mastoid cutaneous fistula (n = 1), dehiscence in blind sac closure (n = 1), and electrode exposure (n = 1). Four studies assessed the postoperative quality of life/patient satisfaction, showing improved outcomes. Conclusion CI could be considered to be feasible and safe in patients with irradiation-induced SNHL. The adverse events of CI in such cases are manageable. Future studies are needed to be strengthened this context.

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Section: Complicationsmentioning

confidence: 99%

Cochlear Implantation in Radiation-Induced Hearing Loss: A Systematic Review

Alahmadi

Abdelsamad²,

Al-Zuraiqi

et al. 2023

Otol Neurotol

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Optimizing Hearing Outcomes in Nasopharyngeal Cancer Survivors in the Era of Modern Radiotherapy and Systemic Therapy

Ho,

Ma,

Chow

2024

Cancers

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Intensity-modulated radiation therapy (IMRT) improves disease control and reduces treatment-related toxicity in patients with localized nasopharyngeal carcinoma (NPC). However, due to the proximity of the auditory apparatus to the treatment volume and the frequent incorporation of cisplatin-based chemotherapy, treatment-related sensorineural hearing loss (SNHL) remains a common debilitating complication among NPC survivors. The reported crude incidence of SNHL following IMRT for NPC varies widely at 1–46% due to differences in auditory assessment methods and thresholds, follow-up durations, chemotherapy usage, and patient compositions. International guidelines and radiation dosimetric studies have recommended constraining the cochlear mean dose to less than 44–50 Gy, but the risk of SNHL remains high despite adherence to these constraints. Potential strategies to improve hearing outcomes in NPC survivors include cautious de-escalation of radiotherapy dose and volume, individualization of cochlear constraints, optimization of radiotherapy planning techniques, and the use of substitutes or alternative schedules for cisplatin-based chemotherapy. The addition of immune checkpoint inhibitors to chemoradiotherapy did not impact ototoxicity. Prospective studies that employ both objective and patient-reported auditory outcomes are warranted to test the long-term benefits of various approaches. This article aims to provide a comprehensive review of the incidence and radiation dose–toxicity relationship of SNHL in NPC survivors and to summarize potential strategies to optimize hearing outcomes in relation to nuances in radiotherapy planning and the selection of systemic therapy.

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Management Options for Patients With Nasopharyngeal Carcinoma Undergoing Cochlear Implantation

Cited by 2 publications

References 20 publications

Cochlear Implantation in Radiation-Induced Hearing Loss: A Systematic Review

Cochlear Implantation in Radiation-Induced Hearing Loss: A Systematic Review

Optimizing Hearing Outcomes in Nasopharyngeal Cancer Survivors in the Era of Modern Radiotherapy and Systemic Therapy

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