Hearing loss associated with maxillectomy

Little has been reported about the effect on auditory tube function of ablative surgery for maxillary neoplasms. Operations on the muscles of the soft palate may cause conductive hearing loss by impairing the opening of the auditory tube, which results in a middle ear effusion. Sensorineural hearing loss may also follow adjuvant radiotherapy. In this retrospective study we aimed to assess hearing status in patients who had undergone maxillary surgery for neoplastic disease between 1987 and 1997. Data recorded included personal details, site and size of lesion, treatment, and histology. Thirty-eight patients were identified, of whom 26 had survived and were contacted. Seventeen of the 26 had had part of the soft palate excised. All patients underwent tympanometry and had a pure tone audiogram. Audiograms showed an air-bone gap of > 10 dB in the ear on the side of the operation in 11 of those 17 patients. All 17 patients who had had soft palate resections had evidence of auditory tube insufficiency on tympanometry. Seven of the nine patients who had had radiotherapy had substantial sensorineural hearing loss. We conclude that conductive hearing loss is dependent on the site of resection; tympanometry is a sensitive test of middle ear function; sensorineural hearing loss may often follow radiotherapy; and audiological assessment is essential both before and after operation in patients having maxillary resections.