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Related Experiment Video

Updated: Aug 24, 2025

Surgical Induction of Endolymphatic Hydrops by Obliteration of the Endolymphatic Duct
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Post-irradiation endolymphatic hydrops vs. post-irradiation sudden deafness.

Chung-Tang Tien1, Chun-Nan Chen1, Yi-Ho Young1

  • 1Departments of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|October 20, 2022
PubMed
Summary

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Acute sensorineural hearing loss (SNHL) in irradiated nasopharyngeal carcinoma (NPC) survivors can be differentiated using MR imaging. This helps distinguish post-irradiation endolymphatic hydrops (PIEH) from post-irradiation sudden deafness (PISD) for appropriate treatment.

Area of Science:

  • Otorhinolaryngology
  • Radiology
  • Oncology

Background:

  • Nasopharyngeal carcinoma (NPC) survivors treated with radiation are increasingly experiencing acute sensorineural hearing loss (SNHL).
  • Differentiating the causes of SNHL in these patients is crucial for effective management.
  • Two potential causes are post-irradiation sudden deafness (PISD) and post-irradiation endolymphatic hydrops (PIEH).

Purpose of the Study:

  • To utilize MR imaging to distinguish between PIEH and PISD in long-term NPC survivors presenting with acute SNHL.
  • To identify imaging and clinical characteristics that differentiate these two conditions.

Main Methods:

  • A cohort of 10 irradiated NPC survivors with acute SNHL was studied between 2012 and 2021.
  • All patients underwent a comprehensive inner ear test battery and MR imaging with the HYDROPS-Mi2 technique.
Keywords:
Acute sensorineural hearing lossHYDROPS-Mi2 techniqueMR imagingNasopharyngeal carcinoma (NPC)Post-irradiation endolymphatic hydrops (PIEH)Post-irradiation sudden deafness (PISD)

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  • Diagnosis of PIEH was based on positive cochlear hydrops on MR imaging, while PISD was diagnosed in the absence of hydrops.

    • Main Results:

    • Six patients (11 ears) were diagnosed with PIEH (cochlear hydrops positive), and 4 patients (4 ears) with PISD (cochlear hydrops negative).
    • No significant differences were observed in the time from NPC onset to SNHL, symptoms, radiotherapy details, audiological, or vestibular findings between PIEH and PISD.
    • PIEH predominantly affected both ears (5/6), while PISD was unilateral (4/4). Inner ear test abnormalities declined progressively in PIEH patients but not in PISD patients.

    Conclusions:

    • MR imaging with the HYDROPS-Mi2 technique is recommended for differentiating PIEH from PISD in irradiated NPC survivors with acute SNHL.
    • Accurate differentiation is essential due to distinct treatment strategies and potential hearing outcomes for PIEH and PISD.