Chemoradiotherapy Induced Hearing Impairment in Head and Neck Malignancies

Hearing impairment after treated by radio/chemotherapy for head and neck malignancies may compromise patients' communication and make them socially handicap. Thus, early detection of hearing loss may provide early access to hearing rehabilitation facilities and improve their quality of life. The present study was a 1-year prospective observational study conducted at tertiary care center, Jaipur, India. Total 90 patients treated with radio/chemo or combined therapy for head and neck malignancies were included in our study. Evaluation of type and degree of hearing loss with pure tone audiometry was done Pretreatment and Posttreatment at 1- and 6-months interval and data analyzed. Most common type of modality received by study population was chemoradiotherapy (41.1%) followed with radiotherapy (36.7%) and least common modality was chemotherapy (22.2%). We observed in our study that 50% of patients who received chemotherapy, 48.5% with radiotherapy and 81.1% patients who received concurrent chemoradiotherapy develops sensorineural hearing loss (SNHL) of various grade. Patients who were exposed with high dose of cisplatin developed more severe SNHL (44.44% grade 2, 44.44% grade 3 and 11.1% grade 0) when compared with low dose group of patients (81.8% grade 0 and 18.18% grade 2) and results were found significant (P value less than 0.05). Chemotherapy, with or without radiotherapy can cause hearing loss and it should be monitored to avoid permanent impairment Additionally, it can also guide the dosage to be delivered based on the patient's conditions, and if necessary, a more toxic drug can be replaced with a less toxic drug that is similarly efficient.