Radiotherapy that includes the inner ear, particularly for nasopharyngeal cancer, and cisplatin given with it can both cause sensorineural hearing loss that progresses for years. Middle-ear effusion is also common after nasopharyngeal irradiation. Arrange a baseline audiogram before treatment, repeat it after treatment and at least yearly during follow-up, and examine the ears for effusion at each visit. Ask about tinnitus and difficulty in conversation. Progressive loss is a reason to refer for hearing aids or implant assessment, not an inevitable consequence to accept.
- Get a baseline audiogram before radiotherapy or cisplatin
- Repeat audiometry after treatment and at least yearly in follow-up
- Check for middle-ear effusion at every visit after nasopharyngeal radiotherapy
- Refer progressive loss for hearing aids or implant assessment
Why it matters
Hearing loss after cancer treatment is common, progressive and often left unaddressed.
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