鼻咽癌患者合併中耳積液之聽力長期縱向評估

A Longitudinal Hearing Analysis in Nasopharyngeal Carcinoma Patients with Middle Ear Effusion

黃薰嫺(Hsun-Hsien Huang) ； 方富民(Fu-Min Fang) ； 楊麗娜(Li-Na Yang) ； 楊昭輝(Chao-Hui Yang) ； 賴啟智(Chi-Chih Lai) ； 黃仲鋒(Chung-Feng Hwang)

《台灣耳鼻喉頭頸外科雜誌》 48卷4期 (2013/12) Pp. 258-264

https://doi.org/10.6286/2013.48.4.258

摘要

BACKGROUND: To investigate the level of hearing loss after radiation treatment in nasopharyngeal carcinoma (NPC) patients with middle ear effusion (MEE).METHODS: A retrospective study of from 45 NPC patients, treated with radiotherapy ± chemotherapy from 1994-2010 was performed. Patients were divided into surgery group (44 individual ears from 25 patients), and conservative group (27 individual ears from 20 patients). Pure tone audiograms were analyzed in these two groups.RESULTS: There are 71 individual ears from 45 NPC patients. After radiation treatment for NPC patients with MEE, there were significant deterioration of bone conduction (BC) and air conduction (AC) thresholds (p＜0.001). Deterioration of the mean hearing threshold 1-3 years after surgical treatment was milder than that following conservative treatment. (AC threshold 9.29 dB HL vs. 14.13 dB HL, p=0.294; BC threshold 4.43 dB HL vs. 9.40 dB HL, p=0.074). After long-term (4-5 years) follow-up, however, deterioration of the mean hearing threshold was not significantly different (AC threshold 21.82 dB HL vs. 20.96 dB HL, p=0.899; BC threshold 15.48 dB HL vs. 14.35 dB HL, p=0.799).CONCLUSIONS: Hearing status in NPC patients with MEE were significantly deteriorated post-radiation. Threshold deterioration may benefit from surgery in 1-3 years follow up. However, there was no significant difference in long term (4-5 years) follow up.

關鍵字

鼻咽癌(nasopharyngeal carcinoma) ； 中耳積液(middle ear effusion) ； 鼓膜切開術(myringotomy) ； 純音聽力圖(pure tone audiogram)

並列摘要

BACKGROUND: To investigate the level of hearing loss after radiation treatment in nasopharyngeal carcinoma (NPC) patients with middle ear effusion (MEE).METHODS: A retrospective study of from 45 NPC patients, treated with radiotherapy ± chemotherapy from 1994-2010 was performed. Patients were divided into surgery group (44 individual ears from 25 patients), and conservative group (27 individual ears from 20 patients). Pure tone audiograms were analyzed in these two groups.RESULTS: There are 71 individual ears from 45 NPC patients. After radiation treatment for NPC patients with MEE, there were significant deterioration of bone conduction (BC) and air conduction (AC) thresholds (p＜0.001). Deterioration of the mean hearing threshold 1-3 years after surgical treatment was milder than that following conservative treatment. (AC threshold 9.29 dB HL vs. 14.13 dB HL, p=0.294; BC threshold 4.43 dB HL vs. 9.40 dB HL, p=0.074). After long-term (4-5 years) follow-up, however, deterioration of the mean hearing threshold was not significantly different (AC threshold 21.82 dB HL vs. 20.96 dB HL, p=0.899; BC threshold 15.48 dB HL vs. 14.35 dB HL, p=0.799).CONCLUSIONS: Hearing status in NPC patients with MEE were significantly deteriorated post-radiation. Threshold deterioration may benefit from surgery in 1-3 years follow up. However, there was no significant difference in long term (4-5 years) follow up.