Radiotherapy Induced Middle Ear Morbidities in Head and Neck Cancer Patients
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Abstract
Introduction
Although post radiotherapy (RT) otological complications are complex and common, there is lack of data on its severity and spectrum. We intend to assess the incidence and severity of such ototoxicities in head neck cancer (HNCA) patients.
Materials and Methods
One year prospective study was conducted on thirty cases of HNCA receiving radiotherapy. Audiometry and tympanometry changes were noted and severity is assessed using Common Toxicity Criteria (CTC) -v2.0 of the National Cancer Institute (NCI). Fisher's Exact Test with two-sided p value was used for comparison of the tympanometric changes.
Results
The mean age was 55.4 years. The commonest site of HNCA was oral cavity (30%) with 46.6 % in stage II. 40% of cases were in grade II, followed by 27% cases in Grade III. The commonest complaint was pain (86.6%), hearing loss (80%) and 40% post-RT cases reporting Type B curve (relative risk 0.67).
Conclusion
Post-irradiation pain and OME are a major concern in HNCA patients having grade II (NCI-CTC). Early detection and prophylactic measures will improve the quality of life in such group of patients. This result validates the need for formulating otological diagnostic strategy & therapeutic measures in patients receiving RT to mitigate post-irradiation ototoxicities.
Article Details
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References
Bhattacharjee A, Chakraborty A, Purkaystha P. Prevalence of Head and Neck Cancer in the North – East India – An institutional study. Indian Journal Otolaryngol Head Neck Surg. 2006; 58 :1;15-9
Barbara A, Jereckzek Fossa, Andrzej Zarowski et al Radiotherapy induced ear toxicity. Cancer treatment reviews 2003; 29:417-30
Borsanyi SJ, Blanchard CL. Ionizing radiation and the ear. JAMA 1962; 181:958-61
Carls JL, Mendenhall WM, Morris CG, et al. External auditory canal stenosis after radiation therapy. Laryngoscope 2002; 112:1975-8
Bhandare N, Antonelli PJ, Morris CG, Malayapa RS, Mendenhall WM. Ototoxicity after radiotherapy for head and neck tumors. International Journal of Radiation Oncology Biology Physics 2007; 67(2): 469-79
Jereczek-Fossa BA, Zarowski A, Milani F, Orecchia R. Radiotherapy-induced ear toxicity. Cancer Treat Rev. 2003; 29(5):417-30. doi: 10.1016/s0305-7372(03)00066-5
Bhide SA, Harrington KJ, Nutting CM. Otological toxicity after postoperative radiotherapy for parotid tumours. Clinical Oncology 2007; 19:77-82
Raaijmakers E, Engelen AM. Is sensorineural hearing loss a possible side effect of nasopharyngeal and parotid irradiation? A systematic review of the literature. Radiother Oncol. 2002; 65(1):1-7. doi: 10.1016/s0167-8140(02)00211-6
Sikand A, Longridge N. CSF otorrhea complicating osteoradionecrosis of the temporal bone. J Otolaryngol. 1991; 20:209-11
Leonetti JP, Origitano T, Anderson D, et al. Intracranial complications of temporal bone osteoradionecrosis. Am J Otol.1997; 18:223-8
Chen WC, Liao CT, Tsai HC, Yeh JY, Wang CC, Tang SG, Hong JH. Radiation-induced hearing impairment in patients treated for malignant parotid tumor. Ann Otol Rhinol Laryngol. 1999;108(12):1159-64
Young YH, Cheng PW, Ko JY. A 10-year longitudinal study of tubal function in patients with nasopharyngeal carcinoma after irradiation. Arch Otolaryngol Head Neck Surg. 1997; 123:945-8.