[Radiation-induced ototoxicity during the treatment of head, neck and skull base cancers]

Radiotherapy, with or without cisplatin, is a cornerstone in the treatment of head and neck cancers and skull base tumors. However, it poses a significant risk of ototoxicity, affecting the cochlea and vestibular apparatus, with major repercussions on hearing, balance, and overall quality of life. Patients may experience hearing loss, tinnitus, or vestibular disorders that can be debilitating. This toxicity stems from complex mechanisms, including direct damage to sensory cells, local ischemia, and inflammatory responses, leading to a progressive decline in auditory and vestibular functions. Despite technical advances such as intensity-modulated radiotherapy (IMRT), which helps limit doses to auditory structures, these side effects remain common. Rigorous audiometric monitoring and optimization of therapeutic protocols are essential to mitigate their impact. Radiation-induced ototoxicity remains a major challenge in head and neck oncology, requiring a multidisciplinary approach to preserve patients' quality of life.