- Design
- Systematic review of 12 observational studies
- Population
- 69 ears with hearing loss after radiotherapy for nasopharyngeal carcinoma
- Primary outcome
- Audiometric improvement and complications after cochlear implantation
- Effect
- Improvement 91.3% (95% CI 73.1 to 98.8); free of postoperative complications 96.5%
A systematic review in The Laryngoscope (published 29 September) pooled 12 studies of cochlear implantation in 69 ears of patients with hearing loss after radiotherapy for nasopharyngeal carcinoma.
Audiometric improvement was seen in about 91% (95% CI 73 to 99), with gains in speech perception and quality of life. About 96% had no postoperative complication. Patients had lived with profound loss for a mean of 6.5 years before implantation, and most were implanted through a standard mastoidectomy approach.
Radiation-induced sensorineural hearing loss is common after nasopharyngeal cancer treatment, which is frequent in parts of Asia including north-east India. These survivors are often not referred because of concern about irradiated bone. The evidence is small and observational, but it supports routine hearing surveillance after radiotherapy and referral for implant assessment when hearing aids fail.
- Arrange audiometry for patients after radiotherapy for nasopharyngeal carcinoma, and repeat it during survivorship.
- Refer survivors with severe to profound loss not helped by hearing aids for cochlear implant assessment.
- Do not treat previous radiotherapy alone as a reason to exclude implantation.
- Check for chronic otitis media with effusion, common after nasopharyngeal radiotherapy, before implantation.
Why it matters
A group often left with hearing aids that no longer help may be good implant candidates.
Don't overread it
This pools 69 ears from small observational studies, so the success rate is imprecise.
The statistics, in plain English
The 91% improvement figure has a wide interval (73% to 99%) because the total number of ears is small.
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