Pure Tone Audiometry Findings before and after Radiotherapy in Head and Neck Cancer Patients: A Hospital-based Prospective Interventional Study

Abstract

Introduction: Radiotherapy is still the major treatment modality for Head and Neck malignancies preferred by patients as well as surgeons. Temporal bone and brain stem are mostly included in the portals. So the middle ear, inner ear and brain stem may receive a significant radiation dose causing hearing loss. Aim: To study the effect of radiotherapy on hearing in patients with head and neck cancer. Materials and Methods: This study was a hospital based prospective interventional study, done in Assam Medical College and Hospital, Dibrugarh, Assam, India, from 1st July, 2020 to 30th June, 2021. A total of 33 patients with head and neck malignancies receiving radiotherapy as a mode of treatment attending Ear Nose Throat (ENT) Outpatient Department (OPD) and Department of Radiation Oncology were included. Pure Tone Audiometry was done for hearing assessment before and after radiotherapy. Microsoft excel version 2010 was used for recording the data. Results: A total of 66 ears (33 patients) have been evaluated. Out of 33 patients, 29 patients (87.88%) had decreased hearing in one/ both the ear after radiotherapy. Out of 29 patients, 19 patients (65.51%) had hearing loss less than 10 dB whereas, 10 patients (30.3%) had hearing loss >10 dB, which is considered as significant hearing loss. Among the 19 patients, 3 patients (15.78%) had hearing loss <10 dB on the same ear, i.e. on the same side of malignancy where the radiotherapy was given. Other 16 patients (48.48%) had hearing loss on both ear. Conclusion: Effect of radiotherapy with or without chemotherapy on hearing is a well known phenomenon. This study also established the fact of hearing loss in majority of patients receiving radiotherapy.