Skip to main content
×
×
Home

Relationship between Eustachian tube dysfunction and otitis media with effusion in radiotherapy patients

  • K Akazawa (a1), H Doi (a2), S Ohta (a1), T Terada (a1), M Fujiwara (a2), N Uwa (a1), M Tanooka (a3) and M Sakagami (a1)...
Abstract
Objective:

This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion.

Methods:

The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose–volume histogram parameters.

Results:

Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes.

Conclusion:

The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.

Copyright
Corresponding author
Address for correspondence: Dr Kazuyuki Akazawa, Department of Otolaryngology – Head and Neck Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501, Japan Fax: +81 798 41 8976 E-mail: a-kazu@hyo-med.ac.jp
Footnotes
Hide All

Presented as a poster at the 120th Annual Meeting of the American Academy of Otolaryngology – Head and Neck Surgery, 20 September 2016, San Diego, California, USA.

Footnotes
References
Hide All
1 Yeh, SA. Radiotherapy for head and neck cancer. Semin Plast Surg 2010;24:127–36.
2 Nutting, CM, Morden, JP, Harrington, KJ, Urbano, TG, Bhide, SA, Clark, C et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 2011;12:127–36.
3 Bluestone, CD. Pathogenesis of otitis media: role of eustachian tube. Pediatr Infect Dis J 1996;15:281–91.
4 Takahashi, H, Hayashi, M, Sato, H, Honjo, I. Primary deficits in Eustachian tube function in patients with otitis media with effusion. Arch Otolaryngol Head Neck Surg 1989;115:581–4.
5 Stenstorm, C, Bylander, GA, Ingvarsson, L. Eustachian tube function in otitis-prone and healthy children. Int J Pediatr Otorhinolaryngol 1991;21:127–38.
6 Iwano, T, Kinoshita, T, Hamada, E, Doi, T, Ushiro, K, Kumazawa, T. Otitis media with effusion and eustachian tube dysfunction in adults and children. Acta Otolaryngol Suppl 1993;500:66–9.
7 Wang, LF, Kuo, WR, Ho, KY, Lee, KW, Lin, CS. A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy. Otol Neurotol 2004;25:168–73.
8 Hsin, CH, Chen, TH, Liang, KL, Tseng, HC, Liu, WS. Postirradiation otitis media with effusion in nasopharyngeal carcinoma patients treated by intensity-modulated radiotherapy. Laryngoscope 2013;123:2148–53.
9 Young, YH, Lin, KL, Ko, JY. Otitis media with effusion in patients with nasopharyngeal carcinoma, postirradiation. Arch Otolaryngol Head Neck Surg 1995;121:765–8.
10 Wakisaka, H, Yamada, H, Motoyoshi, K, Ugumori, T, Takahashi, H, Hyodo, M. Incidence of long-term ipsilateral and contralateral ototoxicity following radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx 2011;38:95100.
11 van Heerbeek, N, van der Avoort, SJ, Zielhuis, GA, Cremers, CW. Sonotubometry: a useful tool to measure intra-individual changes in eustachian tube ventilatory function. Arch Otolaryngol Head Neck Surg 2007;133:763–6.
12 Beleskiene, V, Lesinskas, E, Januskiene, V, Daunoraviciene, K, Rauba, D, Ivaska, J. Eustachian tube opening measurement by sonotubometry using perfect sequences for healthy adults. Clin Exp Otorhinolaryngol 2016;9:116–22.
13 Di Martino, EF, Thaden, R, Antweiler, C, Reineke, T, Westhofen, M, Beckschebe, J et al. Evaluation of eustachian tube function by sonotubometry: results and reliability of 8 kHz signals in normal subjects. Eur Arch Otorhinolaryngol 2007;264:231–6.
14 Ohta, S, Sakagami, M, Suzuki, M, Mishiro, Y. Eustachian tube function and habitual sniffing in middle ear cholesteatoma. Otol Neurotol 2009;30:4853.
15 Wang, SZ, Wang, WF, Zhang, HY, Guo, M, Hoffman, MR, Jiang, JJ. Analysis of anatomical factors controlling the morbidity of radiation-induced otitis media with effusion. Radiother Oncol 2007;85:463–8.
16 Young, YH, Sheen, TS. Preservation of tubal function in patients with nasopharyngeal carcinoma, post-irradiation. Acta Otolaryngol 1998;118:280–3.
17 Wang, SZ, Li, J, Miyamoto, CT, Chen, F, Zhou, LF, Zhang, HY et al. A study of middle ear function in the treatment of nasopharyngeal carcinoma with IMRT technique. Radiother Oncol 2009;93:530–3.
18 Sobin, LH, Gospodarowicz, MK, Wittekind, C, eds. UICC TNM Classification of Malignant Tumours, 7th edn. New York: Wiley-Liss, 2009.
19 Ikehata, M, Ohta, S, Mishiro, Y, Katsura, H, Miuchi, S, Tsuzuki, K et al. Usefulness of the saccharin test for assessment of eustachian tube function in patients with chronic otitis media with perforation. Otol Neurotol 2017;38:60–5.
20 Emami, B, Lyman, J, Brown, A, Coia, L, Goitein, M, Munzenrider, JE et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991;21:109–22.
21 Bhandare, N, Jackson, A, Eisbruch, A, Pan, CC, Flickinger, JC, Antonelli, P et al. Radiation therapy and hearing loss. Int J Radiat Oncol Biol Phys 2010;76:S50–7.
22 Upadhya, I, Jariwala, N, Datar, J. Ototoxic effects of irradiation. Indian J Otolaryngol Head Neck Surg 2011;63:151–4.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 5
Total number of PDF views: 73 *
Loading metrics...

Abstract views

Total abstract views: 314 *
Loading metrics...

* Views captured on Cambridge Core between 18th January 2018 - 18th June 2018. This data will be updated every 24 hours.