Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-24T03:59:57.048Z Has data issue: false hasContentIssue false
  • English
  • Français

Middle ear pressures in patients with nasopharyngeal carcinoma and their clinical significance

Published online by Cambridge University Press:  29 June 2007

W. K. Low
W. K. Low*
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore 0316 Republic of Singapore.
*
Address for correspondence: Dr W. K. Low, Department of Otolaryngology, Singapore General Hospital, Singapore 0316, Republic of Singapore. Fax: 65-2262079
Get access Rights & Permissions [Opens in a new window]

Abstract

There is a paucity of studies investigating middle ear pressures (MEPs) in patients with nasopharyngeal carcinoma (NPC). This paper prospectively examines MEPs in patients with nasopharyngeal carcinoma before and after radiotherapy and discusses their clinical significance. Newly diagnosed patients with nasopharyngeal carcinoma were studied before and at three to 12 months (mean 7.5 months) after radiotherapy. MEPs were measured by tympanometry. Thirty-three patients completed the study. The mean MEP before and after radiotherapy was −55.2 mm water(range −250 to 45 mm water) and −73.1 mm water (range −215 to 35 mm water) respectively. About two-thirds of assessable ears had an increase in negative MEPs after irradiation and the rest had less negative MEPs after irradiation. Those ears which developed post-irradiation middle ear effusions were found to have pre-irradiation negative middle ear pressures of at least −45 mm water. These findings provide possible explanations for some unexplained audiometric observations previously made in patients with nasopharyngeal carcinoma after radiotherapy. Tympanometry before radiotherapy may prove to be useful in identifying ears with a high risk of developing post-irradiation middle ear effusion.

Keywords

Nasopharyngeal neoplasmscarcinomaOtitis media with effusionRadiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 5 , May 1995 , pp. 390 - 393
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bylander, A., Ivarsson, A., Tjernstrom, O. (1981) Eustachian tube function in normal children and adults. Acta Otolaryngologica (Stockholm) 92: 481–491.Google Scholar
Chowdury, C. R., Ho, J. H., Wright, A., Tsao, S. Y., Au, G. K., Tung, Y. (1988) Prospective study of the effects of ventilation tubes on hearing after radiotherapy for carcinoma of nasopharynx. Annals of Otology, Rhinology and Laryngology 97: 142–145.Google Scholar
Dias, A. (1966) Effects on hearing of patients treated by irradiation in the head and neck area. Journal of Laryngology and Otology 80: 276–287.Google Scholar
Elna, A. (1976) Normal gas exchange in the human middle ear. Annals of Otology, Rhinology and Larvngology 85 (suppl.25): 161–164.Google Scholar
Falk, B. (1982) Sniff-induced negative middle ear pressure: study of a consecutive series of children with otitis media with effusion. American Journal of Otolaryngology 3: 155–162.Google Scholar
Finkeistein, Y., Zohar, Y., Talmi, Y. P., Rubel, Y., Shanny, I. (1992) The effects of negative middle ear pressure on hearing. New answers to old questions and a review of the literature. Acta Otolaryngologica (Stockholm) 112: 88–95.Google Scholar
Gronved, A., Moller, A., Jorgensen, L. (1990) Studies on gas tension in the normal ear. Acta Otolaryngologica (Stockholm) 109: 271–277.Google Scholar
Gyo, K., Goode, R. L. (1987) Effects of middle ear pressure changes on umbro vibration. Auris–Nacuc–Larynx (Tokyo) 14: 131–137.CrossRefGoogle Scholar
Hauser, R., Probst, R., Harris, F. P. (1993) Effects of atmosphire variation on spontaneous transiently evoked and distoration product otoacoisustic emmission in normal human ears. Hearting Research 69: 133–145.CrossRefGoogle Scholar
Kitahara, M., Kodama, A., Ozawa, H., Izukura, H. (1994) Mechanism of hearing disturbance due to alteration in atmospheric pressure. Acta Otolaryngologica (Stockholm) 510 (Suppl.): 92–95.CrossRefGoogle ScholarPubMed
Lau, S. K., Wei, W. I., Sham, J. S., Choy, D. T., Hui, I. (1992) Early changes of auditory brain stem evoked response after radiotherapy for nasopharyngeal carcinoma–a prospective study. Journal of Laryngology and Otology 106: 887–892.CrossRefGoogle ScholarPubMed
Low, W. K., Willatt, D. J. (1993) The relationship between middle ear pressure and deviated nasal septum. Clinical Otolaryngology 18: 308–310.CrossRefGoogle ScholarPubMed
Magnuson, B. (1981) On the origin of the high negative pressure in the middle ear space. American Journal of Otolaryngology 2: 1–12.Google Scholar
Magnuson, B., Falk, B. (1983) Eusachian tube malfunction and middle ear disease in new perspective. Journal of Otolaryngology 12: 187–193.Google ScholarPubMed
McBride, T. P., Derkay, C. S., Cunningham, M. J., Doyle, W. J. (1988) Evaluation of non-invasive eustachian tube function tests in normal adults. Laryngoscope 98: 655–658.CrossRefGoogle Scholar
Robinson, D. W. (1991) Long-term repeatibility of pure-tone hearing threshold and its relation to noise exposure. British Journal of Audiology 25: 219–235.CrossRefGoogle ScholarPubMed
Sadé, J. (1994) The nasopharynx, eustachian tube and otitis media. Journal of Laryngology and Otology 108: 95–100.CrossRefGoogle ScholarPubMed
Sadé, J., Luntz, M. (1991) Gas diffusion in the middle ear. Acta Otolaryngologica (Stockholm) 111: 354–357.Google Scholar
Su, C. Y., Hsu, S. P., Lui, C. C. (1993) Computed tomography, magnetic resonance imaging and electromyographic studies of tensor veli palatini muscles in patients with nasopharyngeal carcinoma. Laryngoscope 103: 673–678.CrossRefGoogle ScholarPubMed
Tian, Z. M. (1988) Clinical application of tympanometry in avlators. Aviation–Space–Environmental–Medicine 59: 559–562.Google Scholar
Weiss, M. H., Liberatoie, L. A., Kraus, D. H., Budnick, A. S. (1994) Otitis media with effusion in head and neck cancer patients Laryngoscope 104: 5–7.Google Scholar
Young, Y. H., Hsieh, T. (1992) Eustachian tube dysfunction in patients with nasopharyngeal carcinoma. European Archives of Otorhinolaryngology 249: 206–208.CrossRefGoogle ScholarPubMed