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Secondary Middle-ear Damages in Patients with Head and Neck Cancer after Radiotherapy

Huong LD, Nguyen LP and Nguyen HX

Objective: This study aimed to evaluate the relationship between radiotherapy and Eustachian tube dysfunction, and to investigate the efficacy of treatments by tympanostomy and grommet insertion.

Methods: Patients with head and neck cancer (148 patients) were treated by three–dimensional radiotherapy in the Center of Oncology and Nuclear Medicine, Military Medical 103 Hospital from February 2014 to April 2016. All patients underwent an ear examination (otoscopy), audiometry, and tympanometry test. Those who developed otitis media with effusion and tympanosclerosis were then treated by tympanostomy or myringotomy.

Results: The most common complication after the radiotherapy was found to be Eustachian tube dysfunction, especially otitis media with effusion and tympanosclerosis. Thus, carefully examining and closely monitoring need to be performed to detect patients with secondary middle-ear damages, to successfully cure post-radiotherapy otitis media with effusion, and to minimize possible injury to the middle ear and Eustachian tube. Also, tympanostomy and myringotomy were reported to be the preferable treatments due to their simplicity, high quality, and patients’ compliance.

Conclusion: Eustachian tube dysfunction after radiotherapy treatment was the cause for otitis media with effusion and tympanosclerosis. Furthermore, tympanostomy and grommet insertion were convenient, efficient, and desirable treatments for secondary middle-ear damages in patients with head and neck cancer.