Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (1): 35-39.doi: 10.6040/j.issn.1673-3770.0.2020.133

Previous Articles     Next Articles

Clinical characteristics and prognosis of sudden sensorineural hearing loss in post-irradiated nasopharyngeal carcinoma survivors: a report of 18 cases

TAN Yufang, YI Tianhua   

  1. Department of Otolaryngology and Head and Neck Surgery, the First Affiliated Hospital of Shaoyang University, Shaoyang 422001, Hunan, China
  • Published:2021-02-01

PDF (PC)

167

Abstract: Objective The aim of this study is to analyze the clinical characteristics and prognosis of sudden sensorineural hearing loss(SSNHL)in post-irradiated nasopharyngeal carcinoma(NPC)survivors. Methods Medical records of 18 SSNHL patients diagnosed with NPC(NPC group)between January 2014 and May 2019 were reviewed and analyzed, including age, sex, side, treatment delay time, accompanying symptoms, hearing loss severity, audiogram pattern, interval between SSNHL and NPC, and post-treatment hearing outcome. Results Eighteen patients had unilateral hearing loss, including 10 right ears(55.56%)and 8 left ears(44.44%); the sex distribution comprised of 15 males(83.33%)and 3 females(16.67%); 11 ears(61.11%)were accompanied with tinnitus and 10 ears(55.56%)were accompanied with vertigo; 10 patients(55.56%)exhibited total deafness-type hearing loss, and 12 patients(66.67%)suffered severe or profound hearing loss. The rates of complete recovery, significant recovery, partial recovery, and no recovery after treatment, 1 month post-treatment, and 3 months post-treatment were 5.56%, 11.11%, 16.67%, 66.67%, 5.56%, 16.67%, 16.67%, 61.11%, and 5.56%, 11.11%, 22.22%, and 61.11%, respectively. No statistical difference was observed between the three groups(P>0.05). Hearing gains and contralateral hearing gains were 12.22±5.16 dB HL, 3.61±2.33 dB HL, 13.89±6.88 dB HL, 4.44±2.15 dB HL, 13.33±6.02 dB HL, and 3.89±2.58 dB HL, respectively, and hearing gains were higher than the contralateral hearing gains(P<0.05). Conclusion In this study, post-irradiated NPC survivors with SSNHL demonstrated a severe hearing loss with a high rate of accompanying vertigo, and most audiograms revealed total deafness. Although hearing recovery is poor, active treatment can still improve the hearing prognosis and can even be curative.

Key words: Nasopharyngeal carcinoma, Sudden sensorineural hearing loss, Radiotherapy, Clinical characteristics, Prognosis, Hearing loss

CLC Number: 

  • R739.6
[1] 刘寒波, 赵哲成, 文剑雪, 等. 视频眼震电图对突发性聋伴眩晕患者前庭功能的诊断价值分析[J]. 中国耳鼻咽喉颅底外科杂志, 2019, 25(3):281-284. doi:10.11798/j.issn.1007-1520.201903012. LIU Hanbo, ZHAO Zhecheng, WEN Jianxue, et al. Diagnostic value of video nystagmography for vestibular function evaluation in patients with sudden deafness and Vertigo[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2019, 25(3):281-284. doi:10.11798/j.issn.1007-1520.201903012.
[2] Schreiber BE, Agrup C, Haskard DO, et al. Sudden sensorineural hearing loss[J]. Lancet, 2010, 375(9721):1203-1211. doi:10.1016/S0140-6736(09)62071-7.
[3] 叶毅良, 卢标清. 704例突发性耳聋疗效分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5):44-47. doi:10.6040/j.issn.1673-3770.0.2019.052. YE Yiliang, LU Biaoqing. Therapeutic outcome analysis of 704 cases of sudden deafness[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5):44-47. doi:10.6040/j.issn.1673-3770.0.2019.052.
[4] Lin C, Lin SW, Weng SF, et al. Risk of developing sudden sensorineural hearing loss in patients with nasopharyngeal carcinoma: a population-based cohort study[J]. Head Neck, 2014, 36(2):203-208. doi:10.1002/hed.23278.
[5] Young YH, Lou PJ. Post-irradiation sudden deafness[J]. J Laryngol Otol, 1999, 113(9):815-817. doi:10.1017/s0022215100145281.
[6] 江刚, 刘永红. 以突发听力下降为首发症状的鼻咽癌一例[J]. 听力学及言语疾病杂志, 2003, 11(3):210. doi:10.3969/j.issn.1006-7299.2003.03.033.
[7] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会. 突发性聋的诊断和治疗指南(2005年, 济南)[J]. 中华耳鼻咽喉头颈外科杂志, 2006, 41(5):325. doi:10.3760/j.issn:1673-0860.2006.05.003. Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Chinese Otorhinolaryngology Head and Neck Surgery Society of Chinese Medical Association. Guideline of diagnosis and treatment of sudden deafness[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2006, 41(5):325. doi:10.3760/j.issn:1673-0860.2006.05.003.
[8] Lee HM, Okuda KS, González FE, et al. Current perspectives on nasopharyngeal carcinoma[J]. Adv Exp Med Biol, 2019, 1164:11-34. doi:10.1007/978-3-030-22254-3_2.
[9] Chen YP, Chan ATC, Le QT, et al. Nasopharyngeal carcinoma[J]. Lancet, 2019, 394(10192):64-80. doi:10.1016/s0140-6736(19)30956-0.
[10] Young YH. Irradiated ears in nasopharyngeal carcinoma survivors: a review[J]. Laryngoscope, 2019, 129(3):637-642. doi:10.1002/lary.27303.
[11] Chi FH, Young YH. Inner ear deficits in irradiated nasopharyngeal carcinoma survivors[J]. Laryngoscope, 2015, 125(11):2565-2571. doi:10.1002/lary.25329.
[12] Young YH, Lin CY, Lou PJ, et al. Intracranial relapse of nasopharyngeal carcinoma manifested as sudden deafness[J]. Otol Neurotol, 2001, 22(3):392-396. doi:10.1097/00129492-200105000-00021.
[13] Theunissen EA, Bosma SC, Zuur CL, et al. Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: a systematic review of the literature[J]. Head Neck, 2015, 37(2):281-292. doi:10.1002/hed.23551.
[14] Cho TY, Cheng PW, Young YH. Evolution of postirradiated sudden deafness in nasopharyngeal carcinoma survivors during the past two decades[J]. Laryngoscope, 2016, 126(9):2016-2021. doi:10.1002/lary.25893.
[15] 司楠楠, 索利敏, 靳玲, 等. 伴有眩晕或头晕重度以上突聋患者的临床疗效差异分析[J]. 中国耳鼻咽喉颅底外科杂志, 2018, 24(1):13-16. doi:10.11798/j.issn.1007-1520.201801003. SI Nannan, SUO Limin, JIN Ling, et al. Differential analyses of clinical features and efficacy of severe sudden deafness with Vertigo or dizziness[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2018, 24(1):13-16. doi:10.11798/j.issn.1007-1520.201801003.
[16] Lee HY, Kim DK, Park YH, et al. Prognostic factors for profound sudden idiopathic sensorineural hearing loss: a multicenter retrospective study[J]. Eur Arch Otorhinolaryngol, 2017, 274(1):143-149. doi:10.1007/s00405-016-4276-y.
[17] Chen WC, Jackson A, Budnick AS, et al. Sensorineural hearing loss in combined modality treatment of nasopharyngeal carcinoma[J]. Cancer, 2006, 106(4):820-829. doi:10.1002/cncr.21683.
[18] Zhu W, Chen F, Li J, et al. Dosimetric parameters associated with conductive or sensorineural hearing loss 5 years after intensity-modulated radiation therapy in nasopharyngeal carcinoma[J]. Acta Otolaryngol, 2019,139(3):263-268. doi: 10.1080/00016489.2019.1566778.
[19] Chang H, Tu TY, Wu CS, et al. Is the risk of idiopathic sudden sensorineural hearing loss higher in nasopharyngeal carcinoma than in hypopharyngeal cancer? A population-based study[J]. J Chin Med Assoc, 2020,83(9):865-869. doi: 10.1097/JCMA.0000000000000314.
[20] Chen J, Zhao Y, Zhou X, et al. Methylprednisolone use during radiotherapy extenuates hearing loss in patients with nasopharyngeal carcinoma[J]. Laryngoscope, 2016,126(1):100-103. doi: 10.1002/lary.25527.
[21] 陈平, 唐安洲, 张哲, 等. 鼻咽癌放疗后突发感音神经性聋14例临床分析[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(9):705-708. doi:10.3760/cma.j.issn.1673-0860.2011.09.001. CHEN Ping, TANG Anzhou, ZHANG Zhe, et al. Clinical analyses of sudden sensorineural hearing loss in 14 nasopharyngeal carcinomas following radiotherapy[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2011, 46(9):705-708. doi:10.3760/cma.j.issn.1673-0860.2011.09.001.
[22] 赵俊英, 王建明. 单侧突发性聋与椎基底动脉影像学特征的相关性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(4):47-51. doi:10.6040/j.issn.1673-3770.0.2018.573. ZHAO Junying, WANG Jianming. Correlation between unilateral sudden deafness and imaging features of vertebrobasilar artery[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4):47-51. doi:10.6040/j.issn.1673-3770.0.2018.573.
[23] Schmitt NC, Page BR. Chemoradiation-induced hearing loss remains a major concern for head and neck cancer patients[J]. Int J Audiol, 2018, 57(Sup4):S49-S54. doi:10.1080/14992027.2017.1353710.
[25] King KA, Brewer CC. Clinical trials, ototoxicity grading scales and the audiologist's role in therapeutic decision making[J]. Int J Audiol, 2018, 57(sup4):S89-S98. doi: 10.1080/14992027.2017.1417644.
[26] Chan SL, Ng LS, Goh X, et al. Time course and clinical characterization of cisplatin-induced ototoxicity after treatment for nasopharyngeal carcinoma in a South East Asian population[J]. Head Neck, 2018, 40(7):1425-1433. doi: 10.1002/hed.25112.
[1] YANG Kun, CHEN Lijuan, HE Xiaodan, LIU Zhiqi, SHA Suhua. Comparative study of ototoxicity between kanamycin and 2-hydroxypropyl-β-cyclodextrin [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 6-11.
[2] XU Jia, LI Xin, CHEN Wenjing, GAO Juanjuan, LU Xingxing, YI Haijin. Short-term and long-term outcomes of endolymphatic sac decompression with instillation of local steroids for intractable Meniere's disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 17-21.
[3] HUANG Lan, GAO WeiOverview,CHEN GanggangGuidance. Research progress on the pathogenesis and clinical characteristics of BPPV secondary to inner ear diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 108-113.
[4] CHENG Yao, ZHANG Zhen, YANG Ji, FENG Chengmin, DENG Qicheng, ZHANG Xi, ZHAO Rui, ZHU Xin, WU Junzhi, LIU Hai, DENG Shishan. Expression and clinical significance of CIP2A in hypopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 40-44.
[5] HUA Hongli, LI Song,TAO Zezhang. Research progress of artificial intelligence in the diagnosis and treatment of nasopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 113-119.
[6] MA Ning, CHEN Min, LIU Wei, YANG Yang, SHAO Jianbo, HAO Jinsheng, LIU Bing, ZHANG Xiao, DUAN Xiaomin, ZHANG Qifeng, ZHANG Jie. Clinical characteristics and management of pediatric temporal bone fractures [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 13-19.
[7] HU Chunyan, DANG Panhong, ZHANG Rui, FAN Mengyun. Analysis of audiological and imaging characteristics of 149 children with unilateral sensorineural hearing loss [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 31-36.
[8] ZHANG Fengzhen, WANG Guixiang, ZHAO Jing, WANG Hua, DUAN Qingchuan, LI Hongbin, HEI Mingyan, WENG Jingwen, ZHANG Jie. Clinical characteristics and outcomes of neonates with bilateral vocal cord paralysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 86-90.
[9] PAN Linlin, KONG LingyiOverview, ZHAI Feng, CHEN JieGuidance. Research progress on auditory risk factors and hearing screening methods among neonates [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 131-137.
[10] ZHOU Lamei, JIANG Wen, LIU Wen, QIAO Yuehua. Analysis of factors related to the severity of persistent idiopathic tinnitus [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 70-76.
[11] ZHOU Yuxiang,MIAO Beiping, LU Yongtian. Treatment progress of endoscopic surgery for first diagnosed nasopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 108-112.
[12] ZHONG Liping, GUAN Xilong, WANG Jingjing, TANG Yong. Intratympanic injections and systemic glucocorticoid treatment for sudden hearing loss: a systematic review and Meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 1-10.
[13] LIU Pan, WANG Chuan, ZHAO Zeqi, WU Mei, XU Jifeng, LI Wei, ZHANG Weiqiang, LIU Wen. Five cases of metastatic clear cell carcinoma of the head and neck: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 45-50.
[14] WANG Zhongwei, YANG Lin, GUO Ya, SUN Bin, WANG Yali, MA Xiulong, REN Hongtao, BAO Xing. Analysis of the relationship between miR-429 and miR-200C expression and prognosis in patients with nasopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(3): 81-86.
[15] WEI Ya'nan,CHEN Xi. Progress in chemotherapy and targeted drug therapy for locally advanced head and neck squamous cell carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(3): 118-124.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 84 -87 .
[2] NIU Shanli,CHAI Maowen,LI Zhenxiu . Endoscopic rhinoplasty of inferior turbinate in 60 patients with chronic hypertrophic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 16 -18 .
[3] MENG Qing-guo,LU Yong-tian,FAN Xian-liang .

Association of killer cell immunoglobulin-like receptor gene polymorphisms with nasopharyngeal carcinoma

[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 196 -199 .
[4] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 199 -199 .
[5] WAN Li-jia,LU Hai-tao,JIANG Yi-dao,LIU Hui,LI Qin,SHE La-zhi . Effect of H-uvulopalatopharyngoplasty on obstructive sleep apnea
hypopnea syndrome[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 204 -205 .
[6] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 222 -224 .
[7] JI Xiao-bin,DENG Jia-de,ZANG Lin-quan,WANG Lei,XIE Jun . Blood histamine in guinea pigs with allergic rhinitis[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 228 -230 .
[8] XIANG Deng,LU Yong-tian,SUN Huan-ji . Endoscopic repair for cerebrospinal fluid rhinorrhea in 19 cases and a literature review [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 234 -236 .
[9] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 253 -257 .
[10]
YIN Guo-hua,ZHONG Xiao . Long-term effect of laser reduction on lingua adenoids
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 280 -282 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd