Is Hearing Loss From Radiation Permanent

Tips For Managing Hearing Problems

The following can help you manage hearing problems:

• Ask your health care team if you should avoid alcohol, tobacco products, and caffeine, which can make tinnitus worse.

• Drink plenty of water and other fluids. Getting dehydrated can also make tinnitus worse.

• Ask friends, family members, and co-workers to speak clearly without yelling. Yelling or shouting can make it harder to hear. It can also damage your ears more.

• Practice relaxation techniques and get lots of sleep. Being stressed or tired can make tinnitus worse.

• Control your blood pressure. High blood pressure can cause hearing problems.

• Ask your doctor about medications for nausea or dizziness if you have these problems.

• Protect your ears from loud noises. Loud noise can make hearing problems caused by chemotherapy or other drugs worse.

References For Sensorineural Hearing Loss

Treating The Hearing Loss

If you’ve received cancer treatment and have permanent hearing loss, it’s important to see a hearing care provider for expert help. You may be a good candidate for hearing aids, cochlear implants, or assistive listening devices. Treating hearing loss not only helps you hear better, its also linked health benefits, including a reduced risk of depression and injury-causing falls.

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Does Aging Affect Hearing

Hearing sensitivity also declines as people become older. This medical condition is called presbycusis. Again, just like noise-induced hearing loss, everyone is not affected equally. Age-related hearing loss adds to noise-induced hearing loss. As such hearing ability may continue to worsen even after a person stops work in a noisy environment.

Cancer Research Uk Nurses

• Ross and Wilson Anatomy and Physiology in Health and Illness A Waugh and A GrantElsevier, 2018

• Nasopharyngeal carcinoma: United Kingdom National Multidisciplinary GuidelinesR Simo and othersThe Journal of Laryngology and Otology, 2016. Volume 130, Supplement 2, Pages 97-103

• Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow upP Bossi and others

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References For Conductive Hearing Loss

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Common Side Effect Of Radiation Therapy For Head And Neck Cancer: Hearing Loss

Dec 16, 2010 | Hearing Loss |

Chicago Research published in the November issue of Archives of OtolaryngologyHead & Neck Surgery, one of the JAMA/Archives journals, shows that patients who receive radiation therapy for head and neck cancer are more likely to experience hearing loss and to be more disabled by its effects than those who do not receive such treatment.

Head and neck cancer is the sixth most common type of cancer worldwide, according to background information in the article. Treatment methods include surgery, chemotherapy and radiation therapy, either alone or in combination.

Radiation therapy is increasingly being used on head and neck tumors, and close to 100 percent of the radiation delivered may reach the structures of the auditory system, the authors note.

The study was comprised of 282 individuals, including 141 who had undergone radiation therapy for head and neck tumors and 141 controls, who had never undergone a treatment that placed their hearing at risk. All participants underwent hearing evaluations and completed questionnaires regarding how any hearing loss they had experienced was affecting their lives.

Participants in the radiation treatment group were more likely to be severely impaired by hearing loss . This indicates that, when present, hearing losses were substantially greater and more incapacitating after the radiotherapy, the authors write.

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Hearing Loss More Likely Among Kids

Seventy-five per cent of patients five years old and younger had cisplatin-related hearing loss three years after starting therapy, a 2021 University of British Columbia study shows.

Young children particularly vulnerable to the ototoxic effects of cancer therapies, affirms a 2016 review article in the journal Cancer. This is because the brain and ears are still forming in young childhood, the article notes.

Not only is hearing loss more common in children who take cisplatin, but its also more severe, per ASHA. Plus, even small amounts of hearing loss in high frequencies are a big deal to younger children acquiring language.

Findings That Could Lead To Hearing Loss Treatment And Prevention

The finding that cisplatin is retained in the cochlea indefinitely is important for patient care, Dr. Ivy said.

Hearing loss from cisplatin is not a static injury, it doesnt stay the same. It can progress over time and it can occur late, she added. That suggests that a long-term survivor needs ongoing monitoring of their hearing.

She said it will be up to practitioners to continue this monitoring and to rapidly intervene with devices that assist in hearing, such as hearing aids.

Hearing loss can have a particularly negative impact on children, she said.

If adults develop hearing loss, theyre more acutely aware of it, and are more likely to seek assistance, whereas younger children who develop hearing loss might not notice it as much or be unable to explain the problem, she explained. Since they cant hear very well, they may have trouble paying attention and that could be misconceived as a learning disability or a behavior problem. And yet, if they get the appropriate intervention, they perform at the same level they did prior to receiving platinum.

This is why researchers on Dr. Cunninghams team are trying to find ways to block cisplatin from entering the inner ear. They are looking at the cellular mechanism by which cisplatin is taken up by the cells of the stria vascularis to find ways to block uptake, as well as identify drugs that might target cisplatin itself, and bind it or sequester it before it can get into the inner ear, Breglio said.

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Osseointegrated Hearing Aids In Cancer Patients

Indications of Osseointegrated Hearing Aids

OIHAs are prosthetic devices that bypass the conductive mechanism of the external and middle ear. They directly stimulate the cochlea by bone conduction. OIHAs are indicated in patients with conductive and mixed hearing loss who cannot benefit from either traditional hearing aids or functional middle ear surgery. In the oncologic setting, examples of pathologies causing conductive hearing loss amenable to OIHAs include chronic otitis media, chronic otitis externa, ORN, and absence of the auricle or of the EAC.OIHAs can also be offered to patients with single-sided deafness who may not be able to use Contralateral Routing of Signal hearing aids. This situation may occur in cancer patients undergoing subtotal or total temporal bone resection with sacrifice of the auricle.

Effects of RT and Chemotherapy on Osseointegration

It has been difficult to determine a radiation dose threshold above which survival of OIHAs is in jeopardy. Nader et al could not identify such a relationship between RT dosages and failure rate.Studies looking at craniofacial implants at multiple sites found RT dose thresholds between 30 and 55 Gy.

OIHA Complications

Surgical Technique and Other Considerations

Survivors At Highest Risk For Hearing Loss Are Those Who:

• Had other risk factors for hearing loss before the diagnosis of cancer, such as prior treatment with aminoglycoside antibiotics, low birth weight, or meningitis
• Were younger than 4 years of age at the time that they received treatments that can cause damage to the ear
• Received cisplatin in a total dose of 360 mg/m2 or higher. .
• Received radiation to the ear, brain, nose, sinuses, throat, or mid-facial area behind the cheekbones, especially at doses of 30 Gy or higher
• Had a tumor, surgery, or severe infection that involved the brain, ear, or auditory nerve, or required placement of a shunt
• Received more than one type of treatment that can cause hearing loss
• Had poor kidney function at the time that they received chemotherapy or other medications that can damage hearing

Radiation to the ear or brain can cause inflammation or ear wax buildup in the outer ear, problems with fluid buildup in the middle ear, or stiffness of the eardrum or middle ear bones. Any of these problems can result in conductive hearing loss. Radiation can also damage the sensory hair cells in the inner ear, causing sensorineural hearing loss. Damage from radiation may affect one or both ears, depending on the area of radiation treatment.

Platinum chemotherapy and aminoglycoside antibiotics damage sensory hair cells in the inner ear, causing sensorineural hearing loss. Most often, the effect is similar in both ears and is permanent.

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What Are The Effects Of Cancer Treatment On Hearing

High doses of radiation to the ear or brain can cause inflammation or ear wax buildup in the outer ear, problems with fluid buildup in the middle ear, or stiffness of the eardrum or middle ear bones. Any of these problems can result in conductive hearing loss. Radiation can also damage the sensory hair cells in the inner ear, causing sensorineural hearing loss.

Damage from radiation may affect one or both ears, depending on the area of radiation treatment. Conductive hearing loss may improve over time, but sensorineural hearing loss is usually permanent. Platinum chemotherapy can cause damage to sensory hair cells in the inner ear, resulting in sensorineural hearing loss. Most often, the effect is similar in both ears and is permanent.

Treatment Of Radiation Associated Hearing Loss

Treatment of Postradiation OME and Conductive Hearing Loss

The treatment of postradiation OME remains challenging and controversial. Several management options have been studied: clinical observation, conventional hearing aids, tympanocentesis, myringotomy and aspiration, ventilation tube insertion, intratympanic steroid injections, and implantation of osseointegrated hearing aids .The goals are to create an aerated middle ear and to eliminate conductive hearing loss without producing a chronic perforation or chronically draining ear.

Interest in balloon dilation for ET dysfunction and chronic otitis media has been growing since 2010.Although a recent systematic review reported a low rate of self-limiting complications in the general population, the safety of this procedure has yet to be confirmed in patients who have undergone temporal bone irradiation.Concern has been raised that ET balloon dilation might convert a radiated ET from obstructed to patulous. Furthermore, an irradiated carotid artery might become dehiscent, and ETBD could be disastrous in this situation.

OIHAs may be considered when conventional aids cannot be used, such as with chronic otorrhea or osteoradionecrosis of the ear canal.The possibility of developing progressive sensorineural or mixed hearing loss in an irradiated ear might preclude OIHA candidacy. Nonetheless, more powerful OIHA processors are now available, allowing patients with moderate SNHL up to 65dB to benefit from OIHAs.

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Chemotherapy And Hearing Loss

Chemotherapy refers to the use of powerful chemicals that are capable of killing cancer cells. In some cases, chemotherapy drugs can be “ototoxic,” which means they are harmful to hearing.

About half of all patients who receive the chemotherapy drug cisplatin develop hearing-related side effects including hearing loss, tinnitus and vertigo. This is known as ototoxicity.

Types Of Hearing Problems

Your ear has 3 main parts: the outer ear that you see and the middle and inner parts that you do not. Hearing problems start when 1 or more parts of your ear are damaged.

There are 2 main types of hearing loss.

• Conductive hearing loss. This is when something blocks your outer ear or middle ear. This stops sound from reaching your inner ear, where you “hear” it with your brain. The outer or middle ear might be blocked by earwax or an ear infection. Medical treatment can often fix this type of hearing loss.

• Sensory nerve hearing loss. Something damages your inner ear or the nerve that connects your ear to your brain. This nerve is called the auditory nerve. Damage to the inner ear or auditory nerve is often lifelong.

There are 2 main types of tinnitus.

• Subjective tinnitus. Thismeans only you hear the tinnitus sounds. These can be in the form of ringing, whooshing, humming, buzzing, clicking, hissing, or other sounds. They come from damage to any part of the ear or the hearing nerves.

• Objective tinnitus. Your doctor can hear the sounds you hear inside your ears. Several different health conditions can cause this rare form of tinnitus. These conditions include problems with a heart valve or your blood vessels, and muscle tightening.

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What Monitoring Is Recommended

Testing should be done by an experienced audiologist .

Hearing is usually tested by doing an audiogram. During this test, the person wears earphones and listens for sounds of different pitches and different degrees of loudness. Speech audiometry tests the persons ability to hear single words and sentences. Tympanometry tests the status of middle ear and movement of the eardrum in response to a puff of air.

Prestin Mrna Extraction And Qpcr

On days 3 and 7 after irradiation, the ears of each mouse were sampled. Total RNA of the basilar membrane was eluted with an RNA extraction kit . cDNA was synthesized with a RevertAid First Strand cDNA Synthesis Kit . The reaction components were 2 × SYBR Green Premix EX Taq , forward primer , reverse primer , cDNA , and deionized water for a total volume of 20 L. The PCR parameters were 95°C for 30 s , followed by 40 cycles at 95°C for 5 s , 60°C for 30 s and 60°C for 30 s . The two pairs of primers used in real-time PCR were as follows: prestin,forward primer:5-AGGAGGATATGGAGCCCAATG-3,reverse primer:5-CGGTGCACAACCCCATACA-3 actin, forward primer: 5-TTCTAGGCGGACTGTTACTGAGCTG-3, reverse primer: 5-ACTGCTGTCGCCTTCACCGT-3. The relative expression of prestin mRNA in the control group and the 2Ct values of mice in each group was calculated.

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References For Radiation Induced Hearing Loss:

• Meyer AK, Young NM. Auditory late effects of chemotherapy. Auditory Late Effects of Chemotherapy. Late Effects of Treatment for Brain Tumors. Goldman, S. & Turner, C.D., Editors. New York: Springer, 2009: 195-213.
• Stavas MJ1, Carlson ML2, Attia A1, Jacobson GP2, Rivas A2, Morales-Paliza M1, Wanna GB3.Does radiation dose to the vestibule predict change in balance function and patient perceived dizziness following stereotactic radiotherapy for vestibular schwannoma? Am J Otolaryngol. 2014 May 9. pii: S0196-070900110-0. doi: 10.1016/j.amjoto.2014.05.002.
• Theunissen EA1, Zuur CL, Bosma SC, Lopez Yurda M, Hauptmann M, van der Baan S, de Boer JP, van der Molen L, Rasch CR, Dreschler WA, Balm AJ. Long-term hearing loss after chemoradiation in patients with head and neck cancer..Laryngoscope. 2014 Jun 26. doi: 10.1002/lary.24802.
• Yilmaz YF and others. Sensorineural hearing loss after radiotherapy for head and neck tumors. Otol Neurol 29:461-463, 2008
• Wang LF and others. A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy. Otol Neurotol 25: 168-173, 2004.

What Are Some Other Causes Of Hearing Loss

Noise affects the hearing organs in the inner ear. This fact is why noise-induced hearing loss is sensory-neural type of hearing loss. Certain medications and diseases may also cause damage to the inner ear resulting in hearing loss as well. Generally, it is not possible to distinguish sensory-neural hearing loss caused by exposure to noise from sensory-neural hearing loss due to other causes. Medical judgement, in such cases, is based on the noise exposure history. Workers in noisy environments who are also exposed to vibration may experience greater hearing loss than those exposed to the same level of noise but not to vibration.

Some chemicals are ototoxic that is, they are toxic to the organs of hearing and balance or the nerves that go to these organs. This fact means that noise-exposed workers who are also exposed to ototoxic chemicals may experience more hearing damage than those who exposed to the same noise levels without any exposure to ototoxic chemicals.

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