Audiometric findings in patients with head and neck chemoradiotherapy and radiotherapy: short-term outcomes

Hearing loss is a major concern in the patient with head and neck cancer (HNC) undergoing radiotherapy (RT) and/or chemotherapy (CHT). The present study aimed to assess the incidence of sensorineural hearing loss (SNHL) at 6 months follow-up after RT and/or concurrent Cisplatin-based CHT. 

In this prospective study, 60 patients with histopathologically proven HNC underwent three-dimensional conformal radiotherapy (3DCRT) (35 patients) and concurrent Cisplatin-based CHT and RT (25 patients). The status of the hearing was assessed pre-treatment (baseline), one day, 1, 3 and 6 months after treatment by pure tone audiometry (PTA) and other audiometric tests such as tympanometry (TM), acoustic reflex (AR), and speech audiometry (SA).

In the RT group, SNHL was observed in 18 patients and hearing loss occurred in 47 % (33 of 70 ears) of ears. In the chemo-radiotherapy (CRT) group, SNHL was discerned in 20 patients and hearing loss appeared in 88 % (44 of 50 ears) of ears. Perforation of the tympanic membrane occurred in 2/35 patients in the RT group and 1/25 patients in the CRT group. The AR threshold (ART) of patients with CRT significantly increased compared to the RT group at the end of 6 months after treatment (P <0.05). Meanwhile, there was a significant difference in the speech discrimination score (SDS) and speech recognition threshold (SRT) between the CRT group and RT group at the 6 months after treatment (P <0.05).

The incidence of hearing loss in patients that underwent CRT was higher. The auditory system should be considered as a critical organ at risk (OAR) in treatment planning.