Radiotherapy that includes the cochlea, and cisplatin given with it, cause sensorineural hearing loss that often progresses for years. Many patients are not tested until the loss is advanced.
A baseline and scheduled audiograms let rehabilitation start while it is easiest.
- Get a baseline audiogram before chemoradiotherapy for nasopharyngeal and other skull-base cancers.
- Repeat audiometry after treatment and then at regular intervals, as loss can progress for years.
- Treat middle ear effusion after radiotherapy and watch for otitis externa and osteoradionecrosis.
- Fit hearing aids early when loss appears, and refer for implant assessment when aids no longer help.
Why it matters
Hearing loss after cancer treatment is predictable, and missing it leaves patients isolated for years.
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