- Design
- Systematic review of 12 case series and cohorts
- Population
- 69 ears in patients deafened after radiotherapy for nasopharyngeal carcinoma
- Primary outcome
- Audiometric and speech outcomes; surgical complications
- Effect
- Improvement 91.3% (95% CI 73.1 to 98.8); no postoperative complication 96.5%
A systematic review pooled 12 studies, totalling 69 implanted ears, of cochlear implantation in patients with profound hearing loss after radiotherapy for nasopharyngeal carcinoma. Published in The Laryngoscope on 29 September 2026.
Most implants were placed through a standard mastoidectomy and posterior tympanotomy. Complications were uncommon: 80.4% had no intraoperative complication and 96.5% no postoperative complication. Audiometric improvement was seen in 91.3% (95% CI 73.1 to 98.8), with gains in speech perception and quality of life. Patients had been profoundly deaf for a mean of 6.5 years before implantation.
The evidence is small and from case series, so precise rates are uncertain, and irradiated temporal bone carries real risks of wound breakdown and osteoradionecrosis that need experienced surgeons. But the direction is consistent: radiation-induced deafness is not a contraindication, and long duration of deafness did not prevent benefit. Nasopharyngeal carcinoma is more common in north-east India, where this matters most.
- Consider referring patients with profound hearing loss after nasopharyngeal radiotherapy for cochlear implant assessment
- Do not treat previous radiation alone as a reason to rule out implantation
- Do not assume long-standing deafness rules out benefit
- Assess the irradiated ear and skin for healing risk before surgery
- Build routine audiometry into survivorship follow-up
Why it matters
Many survivors live with deafness that could be treated because nobody refers them.
Don't overread it
Based on 69 ears from small case series; complication and benefit rates are imprecise.
The statistics, in plain English
The 91.3% improvement figure has a wide interval, from 73% to 99%, because the total number of ears is small. Case series without a comparison group show what is possible, not exactly how often.
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