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Relationship between Eustachian tube dysfunction and otitis media with effusion in radiotherapy patients

Published online by Cambridge University Press:  18 January 2018

K Akazawa ,
H Doi ,
S Ohta ,
T Terada ,
M Fujiwara ,
N Uwa ,
M Tanooka  and
M Sakagami
K Akazawa*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya City, Japan
H Doi
Affiliation:
Department of Radiology, Hyogo College of Medicine, Nishinomiya City, Japan
S Ohta
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya City, Japan
T Terada
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya City, Japan
M Fujiwara
Affiliation:
Department of Radiology, Hyogo College of Medicine, Nishinomiya City, Japan
N Uwa
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya City, Japan
M Tanooka
Affiliation:
Department of Radiological Technology, Hyogo College of Medicine College Hospital, Nishinomiya City, Japan
M Sakagami
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya City, Japan
*
Address for correspondence: Dr Kazuyuki Akazawa, Department of Otolaryngology – Head and Neck Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501, Japan Fax: +81 798 41 8976 E-mail: [email protected]
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Abstract

Objective:

This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion.

Methods:

The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose–volume histogram parameters.

Results:

Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes.

Conclusion:

The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.

Keywords

Head And Neck CancerRadiotherapyOtitis Media With EffusionRadiotherapyIntensity-Modulated
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 2 , February 2018 , pp. 111 - 116
Copyright
Copyright © JLO (1984) Limited 2018 

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Footnotes

Presented as a poster at the 120th Annual Meeting of the American Academy of Otolaryngology – Head and Neck Surgery, 20 September 2016, San Diego, California, USA.

References

1 Yeh, SA. Radiotherapy for head and neck cancer. Semin Plast Surg 2010;24:127–36.Google Scholar
2 Nutting, CM, Morden, JP, Harrington, KJ, Urbano, TG, Bhide, SA, Clark, C et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 2011;12:127–36.Google Scholar
3 Bluestone, CD. Pathogenesis of otitis media: role of eustachian tube. Pediatr Infect Dis J 1996;15:281–91.Google Scholar
4 Takahashi, H, Hayashi, M, Sato, H, Honjo, I. Primary deficits in Eustachian tube function in patients with otitis media with effusion. Arch Otolaryngol Head Neck Surg 1989;115:581–4.Google Scholar
5 Stenstorm, C, Bylander, GA, Ingvarsson, L. Eustachian tube function in otitis-prone and healthy children. Int J Pediatr Otorhinolaryngol 1991;21:127–38.Google Scholar
6 Iwano, T, Kinoshita, T, Hamada, E, Doi, T, Ushiro, K, Kumazawa, T. Otitis media with effusion and eustachian tube dysfunction in adults and children. Acta Otolaryngol Suppl 1993;500:66–9.Google Scholar
7 Wang, LF, Kuo, WR, Ho, KY, Lee, KW, Lin, CS. A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy. Otol Neurotol 2004;25:168–73.CrossRefGoogle ScholarPubMed
8 Hsin, CH, Chen, TH, Liang, KL, Tseng, HC, Liu, WS. Postirradiation otitis media with effusion in nasopharyngeal carcinoma patients treated by intensity-modulated radiotherapy. Laryngoscope 2013;123:2148–53.Google Scholar
9 Young, YH, Lin, KL, Ko, JY. Otitis media with effusion in patients with nasopharyngeal carcinoma, postirradiation. Arch Otolaryngol Head Neck Surg 1995;121:765–8.Google Scholar
10 Wakisaka, H, Yamada, H, Motoyoshi, K, Ugumori, T, Takahashi, H, Hyodo, M. Incidence of long-term ipsilateral and contralateral ototoxicity following radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx 2011;38:95–100.CrossRefGoogle ScholarPubMed
11 van Heerbeek, N, van der Avoort, SJ, Zielhuis, GA, Cremers, CW. Sonotubometry: a useful tool to measure intra-individual changes in eustachian tube ventilatory function. Arch Otolaryngol Head Neck Surg 2007;133:763–6.Google Scholar
12 Beleskiene, V, Lesinskas, E, Januskiene, V, Daunoraviciene, K, Rauba, D, Ivaska, J. Eustachian tube opening measurement by sonotubometry using perfect sequences for healthy adults. Clin Exp Otorhinolaryngol 2016;9:116–22.Google Scholar
13 Di Martino, EF, Thaden, R, Antweiler, C, Reineke, T, Westhofen, M, Beckschebe, J et al. Evaluation of eustachian tube function by sonotubometry: results and reliability of 8 kHz signals in normal subjects. Eur Arch Otorhinolaryngol 2007;264:231–6.CrossRefGoogle ScholarPubMed
14 Ohta, S, Sakagami, M, Suzuki, M, Mishiro, Y. Eustachian tube function and habitual sniffing in middle ear cholesteatoma. Otol Neurotol 2009;30:48–53.Google Scholar
15 Wang, SZ, Wang, WF, Zhang, HY, Guo, M, Hoffman, MR, Jiang, JJ. Analysis of anatomical factors controlling the morbidity of radiation-induced otitis media with effusion. Radiother Oncol 2007;85:463–8.Google Scholar
16 Young, YH, Sheen, TS. Preservation of tubal function in patients with nasopharyngeal carcinoma, post-irradiation. Acta Otolaryngol 1998;118:280–3.Google Scholar
17 Wang, SZ, Li, J, Miyamoto, CT, Chen, F, Zhou, LF, Zhang, HY et al. A study of middle ear function in the treatment of nasopharyngeal carcinoma with IMRT technique. Radiother Oncol 2009;93:530–3.Google Scholar
18 Sobin, LH, Gospodarowicz, MK, Wittekind, C, eds. UICC TNM Classification of Malignant Tumours, 7th edn. New York: Wiley-Liss, 2009.Google Scholar
19 Ikehata, M, Ohta, S, Mishiro, Y, Katsura, H, Miuchi, S, Tsuzuki, K et al. Usefulness of the saccharin test for assessment of eustachian tube function in patients with chronic otitis media with perforation. Otol Neurotol 2017;38:60–5.CrossRefGoogle ScholarPubMed
20 Emami, B, Lyman, J, Brown, A, Coia, L, Goitein, M, Munzenrider, JE et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991;21:109–22.CrossRefGoogle ScholarPubMed
21 Bhandare, N, Jackson, A, Eisbruch, A, Pan, CC, Flickinger, JC, Antonelli, P et al. Radiation therapy and hearing loss. Int J Radiat Oncol Biol Phys 2010;76:S50–7.Google Scholar
22 Upadhya, I, Jariwala, N, Datar, J. Ototoxic effects of irradiation. Indian J Otolaryngol Head Neck Surg 2011;63:151–4.Google Scholar