Irradiated ears in nasopharyngeal carcinoma survivors: A review

Abstract

This article reviews the literature on otological complications in nasopharyngeal carcinoma (NPC) survivals after irradiation during the past three decades. Symptoms of the irradiated ears were assessed from the external ear canal, through the middle ear cavity including the Eustachian tube, and to the inner ear compartments. The development of radioimaging diagnostic techniques, the introduction from adjuvant chemotherapy to concurrent chemoradiotherapy, and the invention of radiotherapeutic equipment to intensity-modulated radiotherapy (IMRT) have increased the survival rate of NPC patients during the past 30 years. The prevalence of cochlear and vestibular deficits has decreased a lot, whereas middle ear complications (i.e., otitis media with effusion and radiation-induced otitis media) do not decline in NPC survivors even in the IMRT era, probably because the medial half of the Eustachian tube receives > 95% of the total dose despite 2DRT or IMRT. Laryngoscope, 2018.

Is the risk of idiopathic sudden sensorineural hearing loss higher in nasopharyngeal carcinoma than in hypopharyngeal cancer? A population-based study

“…This process may narrow the lumen of vessel and reduce the blood supply, causing severe thrombosis and atherosclerosis. 24 – 26 In our findings, patients with NPC had a 6.6-fold higher risk of developing postradiation SSHL compared with patients with hypopharyngeal cancer. We further inferred that when the radiation is much closer to the blood supply of the inner ear, more events of SSHL occur.…”

Radiation Necrosis of the Lateral Skull Base and Temporal Bone

“…13 Although the incidence of ORNTB following primary radiotherapy is less well defined, recent reviews of NPC patients suggest that the condition is relatively rare. 11,25 The latency period between radiation exposure and the development of ORN-related symptoms averages approximately 8 years, but the range varies widely from 6 months to 48 years. 1,4,10,11,[16][17][18][19] In their series of 33 patients, Sharon et al found no correlation between radiation dose to the primary site and the time to development of ORN.…”

The Analysis of Late-Term Otologic Complications Secondary to Treatment and Treatment Methods of Complications in Patients with Nasopharyngeal Cancer

“…Kronik komplikasyonlar ise sebaseöz ve apokrin bezlerin dejenerasyonu sonucu buşon miktarının azalması ve cilt atrofisi, eksternal otit, DKY stenozu, cilt ülserasyonu, kemik nekrozu ve cilt kanseridir. 7 Bu çalışmada; cilt atrofisi en sık görülen (n=101, %82,7) patolojidir. İkinci sırada kronik eksternal otit (n=5, %4,1) yer almaktadır.…”

“…Fibrotik, atrofik otitis media ve ileri olgularda kemikçik nekrozu sonucu İTİK oluşabilir. 3,7 Östaki tüpünün geç fibrozisi, farengeal orifiste veya mukozal atrofi sonucu patent tuba östaki de gelişebilir. 8 Bu çalışmada; en sık muayene bulgusu olarak 41 (%33,6) orta kulak normal olarak değerlendirildi.…”

“…9 Bu patolojilerin dışında mastoidit, osteoradyonekroz, kartilaj nekrozu, skuamöz hücreli kanser başta olmak üzere cilt kanserleri görülebilir. 7 NFK hastalarında %42'ye varan oranlarda işitme kaybı izlenmektedir. 10 Bu çalışmada, işitme kaybı tipleri açısından en sık işitme kaybı tipi; mikst tip işitme kaybı (n=43, %35,2) idi.…”