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Early changes of auditory brain stem evoked response after radiotherapy for nasopharyngeal carcinoma—A prospective study

Published online by Cambridge University Press:  29 June 2007

S. K. Lau ,
W. I. Wei ,
J. S. T. Sham ,
D. T. K. Choy  and
Y. Hui
S. K. Lau*
Affiliation:
the Otorhinolaryngology Unit, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong and the Institute of Radiotherapy and Oncology
W. I. Wei
Affiliation:
the Otorhinolaryngology Unit, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong and the Institute of Radiotherapy and Oncology
J. S. T. Sham
Affiliation:
the Otorhinolaryngology Unit, Queen Mary Hospital, Hong Kong
D. T. K. Choy
Affiliation:
the Otorhinolaryngology Unit, Queen Mary Hospital, Hong Kong
Y. Hui
Affiliation:
the Otorhinolaryngology Unit, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong and the Institute of Radiotherapy and Oncology
*
Dr Sai-kit, Lau, F.R.C.S., Lecturer, Otorhinolaryngology Unit, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong. Fax: (852) 855 1897
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Abstract

A prospective study of the effect of radiotherapy for nasopharyngeal carcinoma on hearing was carried out on 49 patients who had pure tone, impedance audiometry and auditory brain stem evoked response (ABR) recordings before, immediately, three, six and 12 months after radiotherapy. Fourteen patients complained of intermittent tinnitus after radiotherapy. We found that 11 initially normal ears of nine patients developed a middle ear effusion, three to six months after radiotherapy. There was mixed sensorineural and conductive hearing impairment after radiotherapy. Persistent impairment of ABR was detected immediately after completion of radiotherapy. The waves I–III and I–V interpeak latency intervals were significantly prolonged one year after radiotherapy. The study shows that radiotherapy for nasopharyngeal carcinoma impairs hearing by acting on the middle ear, the cochlea and the brain stem auditory pathway.

Keywords

Audiometryevoked responseNasopharyngeal neoplasmsRadiotherapy

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 106 , Issue 10 , October 1992 , pp. 887 - 892
Copyright
Copyright © JLO (1984) Limited 1992

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References

Adler, M., Hawke, M, Berger, G., Harwood, A. (1985) Radiation effects on the external auditory canal. Journal of Otolaryngology, 14(4): 226–232.Google ScholarPubMed
Anniko, M., Borg, E., Hultcrantz, M., Webster, D. B. (1987) Morphological and electrophysiological study of the inner ear and the central auditory pathways following whole body fetal irradiation. Hearing research (Netherlands), 26(1): 95–104.CrossRefGoogle ScholarPubMed
Antonelli, A. R., Bellotto, R., Bertazzoli, M., Busnelli, G. P., Nunez Castro, M., Felisati, G., Romagnoli, M. (1986) Auditory brain stem response test battery for multiple sclerosis patients: evaluation of test findings and assessment of diagnostic criteria. Audiology, 25: 227–238.CrossRefGoogle ScholarPubMed
Berge, G., Brun, A., Hakansson, C. H., Lindgren, M., Nordberg, U. B. (1974) Sensitivity to irradiation of the brainstem. Irradiation myelitis in the treatment of a nasopharynx carcinoma. Cancer, 33: 1263–1268.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Berger, P. S., Bataini, J. P. (1977) Radiation induced cranial nerve palsy. Cancer, 40: 152–155.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Bohne, B. A., Marks, J. E., Glasgow, G. P. (1985) Delayed effects of ionizing radiation on the ear. Laryngoscope, 95: 818–828.CrossRefGoogle Scholar
Borsanyi, S. J., Blanchard, C. L., Thome, B. (1961) The effects of ionizing radiation on the ear. Annals of Otology, Rhinology and Laryngology, 70: 255–262.CrossRefGoogle Scholar
Dias, A. (1966) Effects on the hearing of patients treated by irradiation in the head and neck area. Journal of Laryngology and Otology, 80: 276–287.CrossRefGoogle ScholarPubMed
Elwany, S. (1985) Delayed ultrastructural radiation induced changes in human mesotympanic middle ear mucosa. Journal of Laryngology and Otology, 99: 343–353.Google Scholar
Glass, J. P., Hwang, T. L., Leavens, M. E., Libshitz, H. I. (1984) Cerebral radiation necrosis following treatment of extracranial malignancies. Cancer, 54: 1966–1972.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
Gyorkey, J., Pollock, F. J. (1960) Radiation necrosis of ossicles. Archives of Otolaryngology, 71: 793–796.CrossRefGoogle ScholarPubMed
Hulcrantz, M., Anniko, M., Borg, E. (1985a) Structure and function of the adult cochlea following prenatal irradiation. Ada Otolaryngologica (Stockholm) (supplement), 425: 1–31.Google Scholar
Hulcrantz, M. (1985b) Structure and function of adult inner ear in mouse following prenatal irradiation. Scandinavian Audiology (Suppl), 24: 1–24.Google Scholar
Jewett, D. L., Williston, J. S. (1971) Auditory evoked far fields averaged from the scalp of humans. Brain, 94: 681–696.CrossRefGoogle ScholarPubMed
Kingston, J. E., Abramovich, S., Billings, R. J., Malpas, J. S., Fuller, A. P. (1986) Assessment of the effect of chemotherapy and radiotherapy on the auditory function of children with cancer. Clinical Otolaryngology, 11(6): 403–409.Google Scholar
Kveton, J. E., Sotelo-Avila, C. (1986) Osteoradionecrosis of the ossicular chain. American Journal of Otology, 7: 446–448.Google Scholar
Lam, K. S. L., Tse, V. K. C, Wang, C., Yeung, R. T. T., Ma, J. T. C, Ho, J. H. C. (1987) Early effects of cranial irradiation on hypothalamic-pituitary function. Journal of Clinical Endocrinology and Metabolism, 64(3): 418–424.CrossRefGoogle ScholarPubMed
Lampert, P. W., Davis, R. L. (1964) Delayed effects of radiation on the human central nervous system: ‘Early and late’ delayed reactions. Neurology (Minneapolis), 14: 912–917.CrossRefGoogle ScholarPubMed
Lau, S. K., Wei, W. I., Choy, D., Sham, J. S. T., Engzell, U. C. G. (1988) Brain stem auditory evoked potentials after irradiation of nasopharyngeal carcinoma. Report on two cases with myelopathy of the brain stem. Journal of Laryngology and Otology, 102: 1142–1146.CrossRefGoogle Scholar
Leach, W. (1965) Irradiation of the ear. Journal of Laryngology and Otology, 79: 870–880.Google Scholar
Manz, H. J., Woolley, P. V., Ornitz, R. D. (1979) Delayed radiation necrosis of brain stem related to fast neutron beam irradiation. Case report and literature review. Cancer, 44: 473–479.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Martini, A., Camacchio, F., Fedele, D., Crepaldi, G., Sala, O. (1987) Auditory brain stem evoked responses in the clinical evaluation and follow up of insulin dependent diabetic subjects. Ada Otolaryngologica, 103: 620–627.Google ScholarPubMed
Moretti, J. A. (1976) Sensory neural hearing loss following radiotherapy to the nasopharynx. Laryngoscope, 86: 598–602.CrossRefGoogle Scholar
Nagel, D., Schafer, J. (1984) Changes of cochlear microphonic response after Y-ray irradiation of the inner ear of guinea pig. Archives of Otorhinolaryngology, 241(1): 17–21.CrossRefGoogle ScholarPubMed
Nightingale, S., Schofield, I. S., %Dawes, P. J. D. K. (1984) Visual, cortical somatosensory and brain stem auditory evoked potentials following incidental irradiation of the rhombencephalon. Journal of Neurology, Neurosurgery and Psychiatry, 47: 91–93.CrossRefGoogle Scholar
O'Neill, J. V., Katz, A. H., Skolnik, E. M. (1979) Otologic complications of radiation therapy. Otolaryngology Head and Neck Surgery, 87: 359–363.CrossRefGoogle ScholarPubMed
Qin, D., Hu, Y., Xu, Z., Cai, W., Cao, D., Gu, X. (1988) Analysis of 1,379 patients with nasopharyngeal carcinoma treated by radiation. Cancer, 61: 1117–1124.Google Scholar
Robinson, K., Rudge, P. (1977) Abnormalities of the auditory evoked potential in patients with multiple sclerosis. Brain, 100, Pt 1: 19–40.CrossRefGoogle ScholarPubMed
Schuknecht, T. F., Karmody, C. S. (1966) Radionecrosis of the temporal bone. Laryngoscope, 76: 1416–1428.CrossRefGoogle ScholarPubMed
Selters, W. A., Brackmann, D. E. (1977) Acoustic tumour detection with brain stem electric response audiometry. Archives of Otolaryngology, 103 (4): 81–87.Google Scholar
Smith, B. M., McGinnis, W., Cook, J., Latourette, H. (1979) Central nervous system changes complicating the use of radiotherapy for the treatment of a nasopharyngeal neoplasm in a diabetic patient. Cancer, 43: 2239–2242.Google Scholar
Starr, A., Achor, L. J. (1975) Auditory brain stem responses in neurological disease. Archives of Neurology, 32: 761–768.CrossRefGoogle ScholarPubMed
Tokimoto, X, Kanagawa, K. (1985) effects of X-ray irradiation on hearing of guinea pigs. Ada Otolaryngologica (Stockholm), 100: 266–272.Google Scholar
Wei, W. I., Engzell, U. C. G., Lam, K. H., Lau, S. K. (1987) The efficacy of myringotomy and ventilation tube insertion in middle ear effusion in patients with nasopharyngeal carcinoma. Laryngoscope, 97: 1295–1298.CrossRefGoogle ScholarPubMed