Low W K, Fong K W
Department of Otolaryngology, Singapore General Hospital, Singapore.
Auris Nasus Larynx. 1998 Jan;25(1):21-4. doi: 10.1016/s0385-8146(97)10009-8.
This paper evaluates the hearing status in the long-term, of patients who have had radiotherapy for nasopharyngeal carcinoma (NPC) and also discusses the hearing losses from a disability point of view, which takes into account binaural hearing. Forty patients who have had NPC successfully treated by a single radical course of radiotherapy of 70-80 Gy were studied at 2-12 years (mean 6.2 years) after radiotherapy. Each patient was examined clinically and with a pure-tone audiogram. Averaged hearing thresholds over 0.5, 1.0, 2.0 and 4.0 kHz were evaluated and a value > 30 dB was considered abnormal. The findings were compared with age-matched controls. The median hearing threshold for each ear in NPC patients was found to be 31.9 dB (range 10.0-86.3 dB) and that for controls 17.5 dB (7.5-38.8 dB) (P < 0.0005, Wilcoxon's matched pairs test). In NPC patients, 44 ears (55.0%) had abnormal hearing, of which 17 (21.3%), 5 (6.3%) and 22 (27.5%) ears had predominantly sensori-neural, conductive and mixed hearing losses, respectively. Nineteen ears had middle ear effusions, accounting for the majority of mixed and conductive hearing losses. In terms of individual patients, 8 (20.0%) and 18 (45.0%) patients had abnormal hearing in one year (monaural hearing disability) and both ears (binaural hearing disability), respectively. In conclusion, a substantial proportion of patients who have had radiotherapy for NPC, have hearing disability in the long-term, as compared to normal controls.
本文评估了鼻咽癌（NPC）患者接受放射治疗后的长期听力状况，并从残疾角度讨论了听力损失情况，其中考虑了双耳听力。对40例经70 - 80 Gy单次根治性放疗成功治疗NPC的患者，在放疗后2至12年（平均6.2年）进行了研究。对每位患者进行了临床检查和纯音听力图检查。评估了0.5、1.0、2.0和4.0 kHz的平均听力阈值，阈值> 30 dB被认为异常。将结果与年龄匹配的对照组进行比较。发现NPC患者每只耳朵的中位听力阈值为31.9 dB（范围10.0 - 86.3 dB），对照组为17.5 dB（7.5 - 38.8 dB）（P < 0.0005，Wilcoxon配对检验）。在NPC患者中，44只耳朵（55.0%）听力异常，其中17只耳朵（21.3%）主要为感音神经性听力损失，5只耳朵（6.3%）为传导性听力损失，22只耳朵（27.5%）为混合性听力损失。19只耳朵有中耳积液，占混合性和传导性听力损失的大多数。就个体患者而言，分别有8例（20.0%）和18例（45.0%）患者单耳（单耳听力残疾）和双耳（双耳听力残疾）听力异常。总之，与正常对照组相比，相当一部分接受NPC放疗的患者长期存在听力残疾。
