Skip to main content

Affection of the middle ear after radiotherapy for head and neck tumors

En

Abstract

Aim

The aim of this study is to evaluate the effect of radiotherapy (RT) as one of the modalities of treatment in patients with head and neck tumors on the Eustachian tube and middle ear.

Study design

This is a prospective study.

Material and methods

This study included 20 patients suffering from squamous cell carcinoma of the head and neck other than nasopharynx and parotid. They were treated either by surgery and postoperative radiotherapy or by primary radiotherapy alone or by concomitant chemoradiotherapy. Audiological evaluation was performed both pre-treatment and post- treatment in the form of pure tone threshold audiometry (PTA), tympanometry, stapedius acoustic reflex and eustachian tube (ET) function test.

Results

The 20 patients corresponded to 40 ears which were analyzed. Post RT tympanometry done revealed 16 (40%) ears with normal type A tympanogram and 24 (60%) ears with abnormal tympanometry findings, Post RT ET function test done revealed 7 (17.5%) ears with good ET function and 33 (82.5%) with abnormal ET function, acoustic reflex done post RT revealed 36 (90%) ears with absent acoustic reflex bilaterally and 4 (10%) ears with preserved acoustic reflex and Post RT PTA done revealed 16 (40%) ears with normal PTA, 13 (32.5%) ears with conductive hearing loss (CHL), 8 (20%) ears with sensori neural hearing loss (SNHL) and 3 (7.5%) ears with mixed hearing loss.

Conclusion

Patients with head and neck tumors given RT as one of the modalities of treatment have a high incidence of affection of middle ear function and ET dysfunction as well as development of CHL.

References

  1. 1

    Upadhya I, Jariwala N, Datar J. Ototoxic effects of irradiation. Indian J Otolaryngol Head Neck Surg 2011; 63: 151–154.

    CAS  Article  Google Scholar 

  2. 2

    Coplan J, Post E, Richman R, Grimes C. Hearing loss after therapy with radiation. Am J Dis Child 1981; 135: 1066–1067.

    CAS  PubMed  Google Scholar 

  3. 3

    Bhandare N, Antonelli PJ, Morris CG, Malayapa RS, Mendenhall WM. Ototoxicity after RT for head and neck tumors. Int J Radiat Oncol Biol Phys 2007; 67: 469–479.

    Article  Google Scholar 

  4. 4

    Bursary S, Blanchard G, Borsanyi SJ, Blanchard CL. Ionizing radiation and the ear. JAMA 1962; 181: 958–961.

    Article  Google Scholar 

  5. 5

    Liberman PH, Schultz C, Gomez MV, Carvalho AL, Pellizzon AC, Testa JR, et al. Auditory effects after organ preservation protocol for laryngeal/hypopharyngeal carcinomas. Arch Otolaryngol Head Neck Surg 2004; 130: 1265–1268.

    Article  Google Scholar 

  6. 6

    Dell’Aringa AH, Isaac Mde L, Arruda GV, Dell’Aringa AR, Esteves MC. Audiological findings in patients treated with radiotherapy for head and neck tumors. Braz J Otorhinolaryngol 2010; 76:527–532.

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Hesham A. Fathy MD.

Additional information

Conflicts of interest

None declared.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Cite this article

Negm, H., Mosleh, M., Hosni, N. et al. Affection of the middle ear after radiotherapy for head and neck tumors. Egypt J Otolaryngol 30, 5–9 (2014). https://doi.org/10.4103/1012-5574.127184

Download citation

Keywords

  • tympanometry
  • pure tone audiometry
  • acoustic reflex
  • Eustachian tube function test