鼻咽癌患者放化疗后早期听力学变化  

Short-stage results of audiological change of nasopharyngeal carcinoma patient after radiotherapy and chemotherapy

作　　者：黎柱杨 王春[1] 邓滨[1] 董英花 叶涛[1] 吴伟铭[1] 叶劲彬 何彬[1] 

机构地区：[1]广西梧州市红十字会医院耳鼻咽喉科,543002

出　　处：《中国中西医结合耳鼻咽喉科杂志》2013年第1期33-36,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的研究鼻咽癌患者放化疗后早期的听力学变化。方法按治疗鼻咽癌的方式,将80例(160耳)鼻咽癌患者分为单纯放疗组(40例,80耳)和同期放化疗联合治疗组(简称联合治疗组,40例,80耳),同时选取25例(50耳)无明显耳鼻疾病正常人为对照组。在鼻咽癌患者放化疗治疗前及治疗结束后3个月进行电耳镜检查、纯音测试、鼓室导抗图及咽鼓管功能测试,分析鼻咽癌放化疗后早期的听力学变化。结果鼻咽癌患者放疗后早期大部分多有鼓膜性状的改变,单纯放疗组和联合治疗组患者均呈现听力下降,其中单纯放疗组以传导性听力下降多见(30%,24/80),而联合治疗组以感音神经性(31%,25/80)及混合性听力下降为主(23%,18/80)。两组患者中多数存在咽鼓管功能障碍。结论鼻咽癌患者放化疗后早期听力损害中,放射治疗主要损害中耳及咽鼓管功能,化学治疗以损害内耳为主,放化疗联合治疗加重听力损害。Objective To investigate short stage results of audiological change of nasopharyngeal carcinoma patients after radiotherapy and chemotherapy treatment. Methods According to treatment modus of nasopharyngeal carcinoma, 80 eases（160 ears） patients were divided to simple radiotherapy group（40cases, 80 ears）and radiotherapy with chemotherapy group（combination treatment group, 40 cases, 80 ears）. Meanwhile, 25 cases（50 ears）people took as control group, who had no obviously ear and nose disease. About three months after radiotherapy and chemotherapy treatment completion , three groups were detected by otoseopy , pure tone test, tympanogram and eustachian tube function, respectively. Then, hearing variation of all patients after radiotherapy and chemotherapy treatment were investigated and compared each other. At the same time. the character and level of audiological change were also analyzed. Results Eardrum character of nasopharyngeal carcinoma patients appeared change after radiotherapy. Simple radiotherapy and combination treatment groups were found having hearing impairment and eustachian tube functional disturbance. Moreover, most patients of simple radiotherapy group showed conductive deaf（30%, 24 / 80）, and combination treatment group exhibited mingle（31%, 25 / 80）or sensofineural deafness（23 %, 18 / 80）. Conclusions Recent hearing of nasopharyngeal carcinoma patients were damaged by radiotherapy and chemotherapy treatment, radiotherapy treatment induced middle ear or eustachian tube function disturbance, chemotherapy treatment had cochleotoxicity , compared with other treatment, combination treatment was more aggravated heating impairment.

关 键 词：鼻咽肿瘤 放射疗法 同期放化疗 中耳炎 

分 类 号：R739.63[医药卫生—肿瘤]