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Radiation effects on the auditory and vestibular systems
Niranjan Bhandare1, William M Mendenhall, Patrick J Antonelli
1Department of Radiation Oncology, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA.
Otolaryngologic Clinics of North America
|September 16, 2009
Summary
Radiation therapy for head and neck tumors can impact the auditory system. Limiting radiation dose to cranial nerve VIII and using fractionation may reduce auditory and vestibular dysfunction after treatment for vestibular schwannomas.
Area of Science:
- Radiation oncology
- Neurosurgery
- Otolaryngology
Background:
- Radiation therapy (RT) is a standard treatment for head and neck tumors, including intracranial and extracranial types.
- Variability in tumor location and size can make it challenging to spare surrounding normal tissues and organs.
- Specific RT techniques like stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy (FSRT), fractionated radiotherapy (FRT), and intensity-modulated radiation therapy (IMRT) can deliver high doses to the auditory system.
Purpose of the Study:
- To discuss the challenges in sparing the auditory system during radiation therapy for head and neck tumors.
- To highlight the unique considerations for radiation therapy in vestibular schwannomas (VS) due to inner ear involvement.
- To explore strategies for mitigating auditory and vestibular dysfunction following radiation treatment for VS.
Main Methods:
- Review of radiation therapy techniques used for head and neck tumors and vestibular schwannomas.
- Discussion of dose delivery to the auditory system by different RT modalities.
- Analysis of factors influencing auditory and vestibular outcomes in patients treated for VS.
Main Results:
- Certain RT modalities, including SRS, FSRT, FRT, and IMRT, pose a risk of high radiation doses to the auditory system.
- Radiation therapy for VS presents unique challenges due to the proximity to the inner ear and potential for pre-existing dysfunction.
- Limiting the radiation dose to cranial nerve VIII and employing fractionation are key strategies to minimize auditory and vestibular complications.
Conclusions:
- Radiation therapy for head and neck tumors requires careful planning to protect the auditory system.
- Fractionation and dose limitation to cranial nerve VIII are crucial for preserving auditory and vestibular function in patients with VS.
- Further research may focus on optimizing RT delivery to balance tumor control and functional preservation.
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