[Tolerance of normal tissues to radiation therapy: ear]

The main objective of this work was to describe, based on a literature survey, the radiation-induced toxicity of the ear and to try to establish the limiting dose. The limiting toxicity was the sensorineural hearing loss. A dose-effect relationship has been described by several authors. Thirty to 40% of patients who are irradiated for head and neck cancer are concerned, but the intensity of the hearing loss tends to depend on the exact localisation of the primary tumour: nasopharyngeal irradiations, paranasal sinusal and parotid irradiation are at greater risk of complication. High frequencies are more vulnerable than the lower ones. Age of patients, as well as baseline hearing abilities, deeply influence the issue. As far as possible, the dose to the inner ear--the cochlea more precisely--should be kept under 40 Gy. In case of association with other causes of toxicity (such as age, low baseline value, association to cisplatin), this dose should be as low as possible. Should carcinologic constraints lead to toxic doses, then patients should be properly informed.