Tinnitus and organ preservation protocols in head and neck cancers treatment: a descriptive review of the literature

Abstract

INTRODUCTION: Head and neck cancer represents the sixth most common cancer group worldwide and significant progress has been made in the non-surgical management. However, the possibility of audiological side effects has increased. In this article we performed a review of the literature to analyze the principal ear side effects derived from non-surgical protocols.EVIDENCE ACQUISITION: We performed a review of the international literature. For each eligible article, we collected the study design, the sample size and the demographical characteristics, the organ preservation protocols, and the findings about tinnitus or hearing loss. Due to the lack of homogeneity of the data extracted we performed a descriptive review of the literature.EVIDENCE SYNTHESIS: Initial search found 350 studies and 332 were excluded; 18 were reviewed in full text; 10 studies met the inclusion criteria. Overall, 3606 patients were included. The number of patients ranged between 43 and 880. The age ranged between 9 and 84 years. The males are 1878 and females are 931. In 796 case the sex was not specified. Seven studies are monocentric and retrospective; two studies are multicentric and retrospective and only one study is prospective, randomized and observational with the patients randomized in three groups. Data on tinnitus or hearing impairment are evaluated by questionaries that analyze the patient-reported outcomes or by auditory evaluation like the pure tone audiometry or the Auditory Brain Recordings.CONCLUSIONS: The management of audiological side effects is fundamental in order to guarantee a good quality of life. and rehabilitation should be started immediately after the therapies. All ENT specialist, head and neck surgeons, oncologists and radiotherapist oncologists must be vigilant about ototoxicity and implement the strategies to decrease additional morbidity due to ototoxicity.