Brainstem auditory evoked potentials after irradiation of nasopharyngeal carcinoma—Report on two cases with myelopathy of the brainstem

Lau, S. K.; Wei, William Ignace; Choy, D.; Sham, Jonathan S. T.; Engzell, U.

doi:10.1017/s0022215100107546

Cited by 5 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2c). In contrast to other studies, we could not detect other radiation-associated clinically relevant cranial nerve neuropathy [15] or hypothalamic pituitary axis dysfunction, as evidenced by normal TSH, thyroxine and cortisol levels [14]. These differences are perhaps due to the field reduction at a dose of 40 Gy in our patient.…”

Section: Discussioncontrasting

confidence: 99%

“…Histological studies have revealed that radiation induces a mucosal edema that impairs eustachian tube patency and produces middle ear fluid collection [18]. SHNL is caused by cochlear and/or retrocochlear damage [15,22]. Radiation-induced labyrinthitis was found in the bone conduction scores of our patient (Fig.…”

Section: Discussionmentioning

confidence: 82%

“…There are a number of possible mechanisms causing hearing loss: a conductive impairment originating in the middle ear and radiation-induced labyrinthitis and/or damage in the auditory nerve/brain stem [8,15]. This hearing loss may result in complete deafness regardless of the underlying mechanisms.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cochlear implantation as a successful rehabilitation for radiation-induced deafness

Formanek

Czerny

Gstœttner

et al. 1998

European Archives of Oto-Rhino-Laryngology

View full text Add to dashboard Cite

Radiotherapy of the head and neck can be associated with conductive and/or sensori-neural hearing loss. We report the case of a 67-year-old man who developed complete bilateral deafness caused by labyrinthitis and radiation-induced neuritis of the acoustic nerve after postoperative radiotherapy of a nasopharyngeal carcinoma. Two years postoperatively extensive clinical workup including computed tomography and magnetic resonance imaging showed no recurrence or secondary brain tumors. To facilitate sound perception a Combi 40 cochlear implant was implanted. Because of fibrosis the insertion depth of the stimulating electrode into the scala tympani was limited and therefore a "short electrode version" was used. Six months after implantation the patient had achieved an excellent environmental sound recognition and moderate speech intelligibility. Present experiences has shown that although radiotherapy can cause damage to the labyrinth and acoustic nerves and central hearing pathways, there may still be surviving auditory nerve fibers that can be stimulated successfully by a cochlear implant.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 82%

See 1 more Smart Citation

Cochlear implantation as a successful rehabilitation for radiation-induced deafness

Formanek

Czerny

Gstœttner

et al. 1998

European Archives of Oto-Rhino-Laryngology

View full text Add to dashboard Cite

show abstract

“…In a prospective study, Kingston et al (1986) found four children who developed abnormally large interaural difference of waves I-V IPLI after RT and chemotherapy for head and neck malignancy. Prolonged waves I-V IPLI were also recorded from two NPC patients who had radiationinduced brain stem myelopathy (Lau et al, 1988).…”

Section: Introductionmentioning

confidence: 99%

Early changes of auditory brain stem evoked response after radiotherapy for nasopharyngeal carcinoma—A prospective study

et al. 1992

Self Cite

View full text Add to dashboard Cite

A prospective study of the effect of radiotherapy for nasopharyngeal carcinoma on hearing was carried out on 49 patients who had pure tone, impedance audiometry and auditory brain stem evoked response (ABR) recordings before, immediately, three, six and 12 months after radiotherapy. Fourteen patients complained of intermittent tinnitus after radiotherapy. We found that 11 initially normal ears of nine patients developed a middle ear effusion, three to six months after radiotherapy. There was mixed sensorineural and conductive hearing impairment after radiotherapy. Persistent impairment of ABR was detected immediately after completion of radiotherapy. The waves I-III and I-V interpeak latency intervals were significantly prolonged one year after radiotherapy. The study shows that radiotherapy for nasopharyngeal carcinoma impairs hearing by acting on the middle ear, the cochlea and the brain stem auditory pathway.

show abstract

Auditory brain stem responses in patients after radiation therapy for nasopharyngeal carcinoma

Grau¹,

Møler²,

Overgaard³

et al. 1992

Cancer

View full text Add to dashboard Cite

Background. The study evaluated the incidence and severity of brain stem myelopathy occurring after radiation exposure in a cohort of patients who received external radiation exposure for nasopharyngeal carcinoma (NPC). Methods. Brain stem function was investigated by auditory brain stem responses (ABR). Results. Four of 21 patients who could be examined had aberrations in ABR. Three patients showed highly abnormal ABR, with no distinctive patterns or peaks. Two of these patients also showed clinical symptoms of brain stem dysfunction, including multiple palsies in cranial and peripheral nerves, whereas the third patient had no clinical signs of brain stem disorders. The fourth patient had minor conduction delays in ABR. The remaining group of 17 patients who could be examined had ABR latency and transmission times similar to those of the control group. None of these patients had neurologic symptoms. Dose‐response analysis showed that patients who received radiation doses of 59 Gy or less to the brain stem had normal ABR, whereas four of six patients who received a dose of 68 Gy had manifest or subclinical brain stem dysfunction. Conclusions. The results emphasize the importance of protecting the brain stem from high‐dose radiation when possible. The results also demonstrate the usefulness of ABR as a supplement to the clinical examination of patients with possible myelopathy occurring after radiation exposure.

show abstract

Brainstem auditory evoked potentials after irradiation of nasopharyngeal carcinoma—Report on two cases with myelopathy of the brainstem

Cited by 5 publications

References 18 publications

Cochlear implantation as a successful rehabilitation for radiation-induced deafness

Cochlear implantation as a successful rehabilitation for radiation-induced deafness

Early changes of auditory brain stem evoked response after radiotherapy for nasopharyngeal carcinoma—A prospective study

Auditory brain stem responses in patients after radiation therapy for nasopharyngeal carcinoma

Contact Info

Product

Resources

About