Effect of Hydrogen Inhalation Therapy on Hearing Loss of Patients With Nasopharyngeal Carcinoma After Radiotherapy

Abstract

ObjectiveTo evaluate the clinical efficacy and safety of hydrogen inhalation in improving hearing loss in patients with long-term survival of nasopharyngeal carcinoma after radiotherapy.MethodsThe eustachian tube dysfunction score, pure tone air conduction threshold, bone conduction threshold, the score of tympanogram and otoscope were prospectively observed in patients with deafness after radiotherapy only or combined radiotherapy and chemotherapy for nasopharyngeal carcinoma. Paired t test and one-way analysis of variance were used to analyze the data before and after treatment.ResultsA total of 17 patients were observed. The median time from radiotherapy to now was 228 months, and the median time from the diagnose of deafness to now was 92 months. After 4 weeks of hydrogen inhalation, the score of eustachian tube dysfunction, air conduction and bone conduction hearing thresholds were significantly reduced, P values were 0.0293, 0.0027, 0.0404, respectively. The mean air-bone gap, the score of otoendoscopy and tympanogram were also decreased, but the differences were not significant (P = 0.2079, P = 0.0536, P = 0.1056). Patients with radiotherapy alone and concurrent chemo-radiotherapy had significantly lower air conduction hearing threshold after hydrogen absorption (P = 0.0142, P = 0.0495). The results of air and bone hearing thresholds before, 4 and 12 weeks after hydrogen inhalation showed a descending trend. The air and bone hearing thresholds before hydrogen inhalation were 74.69 ± 27.03 dB and 45.70 ± 21.58 dB, respectively. At the 12th week, the mean values of air and bone hearing thresholds were the lowest, which were 66.88 ± 20.88 dB and 40.94 ± 18.93 dB, respectively, but there was no significant difference in air and bone hearing thresholds among all groups (P = 0.6755, P = 0.7712). After hydrogen inhalation treatment, no adverse reactions such as nosebleed, chest pain, dyspnea, nausea, vomiting, dizziness, earache and allergic reaction were observed.ConclusionThis is the first prospective study on the effect of hydrogen inhalation on hearing improvement in patients with deafness after radiotherapy/chemotherapy for nasopharyngeal carcinoma, suggesting that continuous hydrogen inhalation may be an alternative rehabilitation therapy for these patients.

Hydrogen Gas Inhalation Attenuates Acute Impulse Noise Trauma: A Preclinical In Vivo Study

“…30 H 2 is however generally considered non-toxic in vivo and has been administered in high concentrations to humans. [11][12][13]19 For example, 67% H 2 was used in the recent audiology study on nasopharyngeal carcinoma patients. 19 ABR thresholds were assessed at baseline and 4 days after noise exposure and likely include both temporal and permanent threshold shifts.…”

“…[11][12][13]19 For example, 67% H 2 was used in the recent audiology study on nasopharyngeal carcinoma patients. 19 ABR thresholds were assessed at baseline and 4 days after noise exposure and likely include both temporal and permanent threshold shifts. 25,31,32 ABR threshold shifts were found at all frequencies, in accordance with previous results on the same experimental model for impulse noise exposure.…”

“… 11 - 13 ,19 For example, 67% H 2 was used in the recent audiology study on nasopharyngeal carcinoma patients. 19 …”

“…The clinical study indicated that inhalation of a mixture of H 2 and oxygen (O 2 ) ≥ 3 hours a day for >4 weeks reduced conductive and sensorineural post-radiotherapy hearing loss. 19 H 2 ’s otoprotective potential was initially shown when H 2 -supplemented culture medium increased the survival of hair cells exposed to antimycin A, an effect that was attributed to reduced hydroxyl radical production. 20 Shortly after, pretreatment with aqueous H 2 given orally against continuous noise 21 and given intraperitoneally against impulse noise 22 were shown to protect the functional hearing of guinea pigs.…”

Rapidly Blocking the Calcium Overload/ROS Production Feedback Loop to Alleviate Acute Kidney Injury via Microenvironment‐Responsive BAPTA‐AM/BAC Co‐Delivery Nanosystem

“…[13] However, due to the fact the solubility of H 2 in the biological environment is typically low (≈0.8 mm, RT), the amount of H 2 absorbed by the body via inhalation routes is insufficient to eliminate the excess ROS produced under pathological conditions. [11,14] More targeted nanocarriers have been designed and applied in recent years to deliver H 2 or H 2 -producing prodrugs to injured cells, rapidly releasing high concentrations of H 2 that diffuse throughout multiple organelle regions of the cell, assuring efficient scavenging of excess ROS. [15] Despite the fact that ROS scavenging can successfully prevent oxidative stress injury, intracellular Ca 2+ overload will continue to stimulate mitochondrial ROS production and exacerbate Ca 2+ inward flow.…”