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目的 研究鼻咽癌对听觉功能损伤的影响。方法 用电测听和脑干听觉诱发电位(ABR)检查相结合的方法,对73例NPC放疗前和其中30例NPC放疗后进行检查。结果 放疗前电测听异常54例,占73.91％在102耳电测听异常中,传音性、感音性和混合性耳聋分别占36.28％、35.29％和28.43％;ABR异常53例,占72.60％,在71耳ABR异常中,听觉电位、脑干听觉电位和脑干电位异常分别占59.16％、32.39％和8.45％;Ⅱ期、Ⅲ期和Ⅳ期电测听异常率分别是42.86％、80.00％和85.71％,ABR异常率分别是50.00％、77.78％和85.71％,Ⅲ期、Ⅳ期这二项异常率分别与Ⅲ期比明显增高(P<0.01和P<0.05)。临床听力、电测听和ABR均正常只占13.70％。放疗后电测听和ABR异常率是90.00％和73.33％。结论 NPC听觉功能损伤达86.30％,并随病情严重而加重,原因可能是癌瘤浸润或压迫和放疗损伤听觉通路不同部位所致。
Objective To study the effect of nasopharyngeal carcinoma on hearing impairment. Methods The combination of electrical audiometry and brainstem auditory evoked potential (ABR) examination was used to examine 73 cases of NPC before radiotherapy and 30 cases of NPC after radiotherapy. Results There were 54 cases of abnormal audiometry before radiotherapy, accounting for 73.91% of the abnormal audiometry in 102 ears. Acoustic, sensorineural and mixed deafness accounted for 36.28%, 35.29% and 28.43%, respectively; ABR abnormalities accounted for 53 cases. 72.60%, among 71 abnormal ABRs, auditory potential, brainstem auditory potential and brainstem potential abnormalities accounted for 59.16%, 32.39%, and 8.45%, respectively; the abnormal rate of electrical audiometry in phase II, III, and IV were 42.86%, respectively. The abnormal rate of ABR was 50.00%, 77.78%, and 85.71% respectively, and the abnormal rate of phase III and IV was significantly higher than that of phase III (P<0.01 and P<0.05). Clinical hearing, electrical audiometry and ABR were normal only 13.70%. Radiological audiometry and ABR abnormalities after radiotherapy were 90.00% and 73.33%. Conclusion The impairment of auditory function in NPC was 86.30%, which was aggravated with the severity of the disease. This may be due to infiltration, oppression and radiotherapy of the carcinoma and radiotherapy.