Intracranial relapse of nasopharyngeal carcinoma manifested as sudden deafness

Objective: To differentiate tumor relapse from postirradiation sudden deafness (PISD) in patients with nasopharyngeal carcinoma(NPC). Study Design: A retrospective study from December 1991 to November 1999. Setting: University hospital. Patients: Twenty-five irradiated NPC patients with sudden deafness were investigated. All patients received local examination of ears, nose, nasopharynx. and throat fields, as well as a battery of audiologic and neurotologic tests. Results: Three patients with sudden deafness within 3 years after irradiation received a diagnosis of tumor relapse. Magnetic resonance imaging revealed cerebellopontine angle metastasis in one and intracranial invasion in two. Comparison of the remaining 22 NPC patients who had PISD showed that the mean interval between the completion of irradiation to the onset of sudden deafness was 10 +/- 5 years. Conclusion: Magnetic resonance imaging should be performed to exclude intracranial relapse if sudden deafness develops in a patient with NPC within 5 years after irradiation.