Irradiated ears in nasopharyngeal carcinoma survivors: A review

This article reviews the literature on otological complications in nasopharyngeal carcinoma (NPC) survivals after irradiation during the past three decades. Symptoms of the irradiated ears were assessed from the external ear canal, through the middle ear cavity including the Eustachian tube, and to the inner ear compartments. The development of radioimaging diagnostic techniques, the introduction from adjuvant chemotherapy to concurrent chemoradiotherapy, and the invention of radiotherapeutic equipment to intensity-modulated radiotherapy (IMRT) have increased the survival rate of NPC patients during the past 30 years. The prevalence of cochlear and vestibular deficits has decreased a lot, whereas middle ear complications (i.e., otitis media with effusion and radiation-induced otitis media) do not decline in NPC survivors even in the IMRT era, probably because the medial half of the Eustachian tube receives > 95% of the total dose despite 2DRT or IMRT. Laryngoscope, 129:637-642, 2019