Post-irradiation endolymphatic hydrops vs. post-irradiation sudden deafness.
Acute sensorineural hearing loss
HYDROPS-Mi2 technique
MR imaging
Nasopharyngeal carcinoma (NPC)
Post-irradiation endolymphatic hydrops (PIEH)
Post-irradiation sudden deafness (PISD)
Journal
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
31
05
2022
revised:
23
09
2022
accepted:
11
10
2022
pubmed:
21
10
2022
medline:
2
12
2022
entrez:
20
10
2022
Statut:
ppublish
Résumé
Increasing numbers of acute sensorineural hearing loss (SNHL) are recently experienced in irradiated nasopharyngeal carcinoma (NPC) survivors. This study adopted MR imaging to differentiate between post-irradiation sudden deafness (PISD) and post-irradiation endolymphatic hydrops (PIEH) in long-term NPC survivors with acute SNHL. From 2012 to 2021, consecutive 10 irradiated NPC survivors with acute SNHL were enrolled. All patients underwent an inner ear test battery and MR imaging using HYDROPS-Mi2 technique. Six patients (11 ears) with positive cochlear hydrops on MR images were diagnosed as PIEH, while another 4 patients (4 ears) without cochlear hydrops on MR images were referred to PISD. The interval from the onset of NPC to acute SNHL did not significantly differ between the PIEH (10 ± 6 years) and PISD (8 ± 2 years). No significant difference was found between the two disorders from any of the symptomatic, radiotherapeutic, audiological, or vestibular perspective. Interestingly, most (5/6) patients with PIEH had bilateral involvement, while all (4/4) patients with PISD showed unilateral affliction. A significantly declining sequence of abnormality rates in the inner ear test battery was noted in the PIEH patients, running from the audiometry (100%), cervical vestibular-evoked myogenic potential (VEMP) test (100%), ocular VEMP test (73%), to the caloric test (36%). However, such declining trend was not observed in patients with PISD. When facing an NPC survivor who had acute SNHL over a prolonged period after irradiation, MR imaging using HYDROPS-Mi2 technique should be performed to differentiate the PIEH from the PISD, since both disorders have various treatment modalities and hearing outcome.
Sections du résumé
BACKGROUND
Increasing numbers of acute sensorineural hearing loss (SNHL) are recently experienced in irradiated nasopharyngeal carcinoma (NPC) survivors.
AIM
This study adopted MR imaging to differentiate between post-irradiation sudden deafness (PISD) and post-irradiation endolymphatic hydrops (PIEH) in long-term NPC survivors with acute SNHL.
METHODS
From 2012 to 2021, consecutive 10 irradiated NPC survivors with acute SNHL were enrolled. All patients underwent an inner ear test battery and MR imaging using HYDROPS-Mi2 technique. Six patients (11 ears) with positive cochlear hydrops on MR images were diagnosed as PIEH, while another 4 patients (4 ears) without cochlear hydrops on MR images were referred to PISD.
RESULTS
The interval from the onset of NPC to acute SNHL did not significantly differ between the PIEH (10 ± 6 years) and PISD (8 ± 2 years). No significant difference was found between the two disorders from any of the symptomatic, radiotherapeutic, audiological, or vestibular perspective. Interestingly, most (5/6) patients with PIEH had bilateral involvement, while all (4/4) patients with PISD showed unilateral affliction. A significantly declining sequence of abnormality rates in the inner ear test battery was noted in the PIEH patients, running from the audiometry (100%), cervical vestibular-evoked myogenic potential (VEMP) test (100%), ocular VEMP test (73%), to the caloric test (36%). However, such declining trend was not observed in patients with PISD.
CONCLUSION
When facing an NPC survivor who had acute SNHL over a prolonged period after irradiation, MR imaging using HYDROPS-Mi2 technique should be performed to differentiate the PIEH from the PISD, since both disorders have various treatment modalities and hearing outcome.
Identifiants
pubmed: 36265683
pii: S0167-8140(22)04504-2
doi: 10.1016/j.radonc.2022.10.010
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
222-227Informations de copyright
Copyright © 2022 Elsevier B.V. All rights reserved.