Effect of head and neck radiotherapy on auditory system

Irradiation of head and neck tumours are increasingly being used and usually involves the region of temporal bone and Eustachian tube. The auditory apparatus which is sensitive to radiation, is often in the field of irradiation leading to numerous hearing complaints. To study the effect of radiotherapy and cisplatin in head and neck malignancy on auditory apparatus affecting hearing function and its effects on external, middle and inner ear. A epidemiological study of 25 cases with proven head and neck malignancy visiting the Radiotherapy department at Madras Medical College from June 2020 to September 2021 were taken up for study. Patients underwent clinical examination and Audiological investigations and were analysed post radiotherapy at 1 months and 6months interval. In this study aural fullness, ear pain, tinnitus, vertigo, otoscopic examination were compared pretreatment 1 month and 6month post radiotherapy. All these ears when followed up after 6 months of radiation therapy incidence of ear fullness, abnormal appearance of tympanic membrane and conductive pattern hearing loss in PTA has reduced by 99% whereas there is increased incidence of tinnitus, vertigo and hearing loss at high frequencies. Radiation therapy with or without chemotherapy is one of the first line of treatments in head and neck malignancy. hearing apparatus are not intentionally included in the radiation field, they do get clinically measurable doses from primary beam entrance, exit and via scatter radiation. radiation exposure causing otitis media and conductive pattern hearing loss is found to be transient.