Abstract
Abstract 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. This is a prospective study. 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. 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. 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.
Highlights
Irradiation has become the therapy of choice for many malignant tumors of the head and neck and is the only treatment for some of them
We aimed to evaluate the effect of RT on the Eustachian tube (ET) and middle ear in patients with head and neck tumors other than nasopharynx and parotid carcinoma and to investigate the possibility of affection of these sites in patients with the radiation field relatively distant from the ear
The pure tone threshold audiometry (PTA) revealed six patients with variable grades of sensorineural hearing loss (SNHL), five of them were with bilateral affection; this did not have any influence on our study as we focused on the ET function
Summary
Irradiation has become the therapy of choice for many malignant tumors of the head and neck and is the only treatment for some of them. In the application of irradiation, its effect on the adjacent normal tissues must be considered. No strategies have been adopted to shield the ear to minimize radiation exposure. Several studies were conducted to describe the Eustachian tube (ET) function and middle ear status in patients with nasopharyngeal carcinoma after radiotherapy (RT) [1]. We aimed to evaluate the effect of RT on the ET and middle ear in patients with head and neck tumors other than nasopharynx and parotid carcinoma and to investigate the possibility of affection of these sites in patients with the radiation field relatively distant from the ear
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