Ho W K, Wei W I, Kwong D L, Sham J S, Tai P T, Yuen A P, Au D K
Division of Otorhinolaryngology, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Head Neck. 1999 Sep;21(6):547-53. doi: 10.1002/(sici)1097-0347(199909)21:6<547::aid-hed8>3.0.co;2-y.
This was a prospective study to evaluate the effect of radical external irradiation on inner ear function after treatment of nasopharyngeal carcinoma.
Pure tone audiograms were performed at regular intervals before, after, and up to 4.5 years following completion of radiotherapy.
Two hundred ninety-four patients (526 ears) were included. Within 3 months after radiotherapy, deterioration of bone conduction threshold at 4 kHz and pure tone average (average of 0.5 kHz, 1 kHz, and 2 kHz) were noted in 164 ears (31%) and 75 ears (14%), respectively. Patients older than 50 years and ears with threshold below 60 dB at 4 kHz before radiotherapy were significant factors (p < 0.01 and p < 0. 001) associated with a 4 kHz loss. In 40% of these ears, recovery was evident at 2 years. With follow-up for 4.5 years, the probability of significant threshold deterioration increased with time.
Sensorineural hearing loss started soon after radiotherapy. Early changes could be reversible while the probability of persistent hearing loss continued to increase.
这是一项前瞻性研究，旨在评估根治性外照射对鼻咽癌治疗后内耳功能的影响。
在放疗前、放疗后以及放疗结束后长达4.5年的时间内定期进行纯音听力图检查。
纳入294例患者（526只耳）。放疗后3个月内，164只耳（31%）出现4kHz骨导阈值恶化，75只耳（14%）出现纯音平均听阈（0.5kHz、1kHz和2kHz的平均值）恶化。年龄大于50岁以及放疗前4kHz阈值低于60dB的耳是与4kHz听力损失相关的显著因素（p<0.01和p<0.001）。在这些耳中，40%在2年时听力明显恢复。随访4.5年，阈值显著恶化的概率随时间增加。
放疗后很快出现感音神经性听力损失。早期变化可能是可逆的，而持续性听力损失的概率持续增加。
