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

Background: 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. materials and methods: 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). results: 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). conclusion: 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.