Effects of radiotherapy for tumors of the larynx and hypopharynx in hearing levels
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20233580Keywords:
Radiotherapy, Larynx, Hypopharynx, Sensorineural hearing loss, Hearing thresholds, High frequency audiometryAbstract
The head and neck oncological patients are susceptible, either because of tumor location or the treatments performed, to changes of their ear structures. Due to close proximity of radiation field to the ear, radiotherapy induces short and long-term toxicities to the external, middle and internal ear. The aim of this study was to evaluate the impact of radiotherapy on the inner ear. We conducted a cross-sectional retrospective study of patients with cancer of the larynx and hypopharynx undergoing radiotherapy alone or adjuvant to surgery. The follow-up period was 1 year. Relevant clinical and audiological variables were analyzed. We included 15 patients, mostly males, with a median age of 66 years. Average hearing threshold (AHT) deterioration was found in 13 ears, with a median of 8.1dB. Mean bone conduction threshold at 4000 Hz, air conduction threshold at 8000 Hz at 12 months and the median of the final air conduction threshold at 10,000 Hz was significantly higher than the pre-treatment. A correlation was observed between final AHT and dosage of radiation per fraction. Thus, for each increase of 1 Gy per fraction there was an increase of 22.13 dB in the final AHT. About half of the patients had deterioration of the final AHT, proving, on the one hand, the sensorineural hearing loss associated with radiotherapy, while emphasizing the need to perform long-term follow-up protocols for early auditory rehabilitation of these patients.
Metrics
References
Strojan P, Hutcheson KA, Eisbruch A, Beitler JJ, Langendijk JA, Lee AWM, et al. Treatment of late sequelae after radiotherapy for head and neck cancer. Cancer Treat Rev. 2017;59:79-92.
Upadhya I, Jariwala N, Datar J. Ototoxic Effects of Irradiation. Indian J Otolaryngol Head Neck Surg. 2011;63:151-4.
Jereczek-Fossa BA, Zarowski A, Milani F, Orecchia R. Radiotherapy-induced ear toxicity. Cancer Treat Rev. 2003;29:417-30.
Bhandare N, Antonelli PJ, Morris CG, Malayapa RS, Mendenhall WM. Ototoxicity after radiotherapy for head and neck tumors. Int J Radiat Oncol Biol Phys. 2007;67:469-79.
Mujica–Mota M, Waissbluth S, Daniel S. Characteristics of radiation-induced sensorineural hearing loss in head and neck cancer: A systematic review. Head Neck. 2013;35:1662-8.
Kumar P. Radiation Therapy for Cancer of the Larynx and Hypopharynx. Cummings Otolaryngology - Head and Neck Surgery. 2020;1677-95.
Ondrey FG, Greig JR, Herscher L. Radiation dose to otologic structures during head and neck cancer radiation therapy. Laryngoscope. 2000;110:217.
Pan CC, Eisbruch A, Lee JS, Snorrason RM, Ten Haken RK, Kileny PR. Prospective study of inner ear radiation dose and hearing loss in head-and-neck cancer patients. Int J Radiat Oncol Biol Phys. 2005;61:1393-402.
Wang LF, Kuo WR, Ho KY, Lee KW, Lin CS. A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy. Otol Neurotol. 2004;25:168-73.
Yilmaz YF, Aytas FI, Akdogan O, Sari K, Savas ZG, Titiz A, et al. Sensorineural hearing loss after radiotherapy for head and neck tumors: a prospective study of the effect of radiation. Otol Neurotol. 2008;29(4):461-3.
Wakisaka H, Yamada H, Motoyoshi K, Ugumori T, Takahashi H, Hyodo M. Incidence of long-term ipsilateral and contralateral ototoxicity following radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx. 2011;38:95-100.
