Cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis

Abstract

Objective To investigate the effects of cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis. Methods A prospective study method was used, and 76 cases of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis from February 2013 to October 2015 in our hospital for diagnosis and treatment were selected. According to the open control paired principle,the patients were equally divided into observation group and control group, each of 38 cases. Both groups received subtotal temporal bone resection in the treatment, and the observation group received cochlear implant therapy. The surgical effect and hearing improvement of two groups were observed. Results All patients successfully completed surgery. In the observation group, the patients showed normal reactions to intraoperative electrode detection and postoperative electrode impedance, without electrode slippage. There were no statistical differences between the two groups in postoperative pneumothorax and other complication (P > 0.05). The sound intensity level of hearing test in postoperative 1 month in the observation group and control group were (21.23±5.22) dB and (28.42±4.19) dB, which was significantly lower than that in the preoperative 1d [(38.24±4.98) dB and (38.12±5.00) dB], with significantly statistical difference (P < 0.05). The postoperative 1 month of hearing and speech score in the observation group were (87.24±2.98) points and (82.10±3.91) points respectively, which were significantly higher than those in the control group [(73.02±5.30) points and (71.84 ±3.11) points] (P < 0.05). The two groups of postoperative 1 months of hearing and speech scores were also significantly higher than those in the preoperative 1 d [observation group: (34.29±3.49) points and (32.10±5.30) points; control group: (33.20±4.14) points and (31.98±4.92) points] (P < 0.05). Conclusion Cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis shows high safety and success rate, which can promote the improvement of hearing and speech ability, and be widely used in clinic. Key words: Nasopharyngeal neoplasms; Temporal bone; Osteonecrosis; Cochlear implants; Subtotal resection; Hearing