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目的 研究鼻咽癌(NPC)患者放疗后听觉功能的损伤与修复。方法 利用电测听和脑干听觉诱发电位(BAEP)对48例初次接受放疗的NPC患者的听觉通路功能进行检测。结果 电测听结果显示听力以高频受损为主,放疗后6个月内以传导性耳聋为主,放疗后12个月以混合性耳聋为主。与放疗前相比,放疗中BAEP之V波的PL显著延长(P<0.05),放疗结束6个月BAEP之Ⅰ、Ⅲ、Ⅴ波的PL和Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ之IPL显著延长(P<0.01)。BAEP在放疗中出现8例异常,至放疗后12个月增加至23例。在追踪检测中发现一些电测听和BAEP异常病例好转,放疗后3～6个月好转率最高。结论 鼻咽癌放疗后听觉通路损伤可能包括整个听通路。放疗后6个月内是损伤与修复并存的最活跃时期,应是治疗听觉损伤的最佳时期。
Objective To study the damage and repair of auditory function in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods The auditory pathways of 48 patients with initial radiotherapy for NPC were tested by electrical audiometry and brainstem auditory evoked potentials (BAEP). Results The results of electrical audiometry showed that the hearing loss was mainly at high frequency. Conductive deafness was the most common within 6 months after radiotherapy. Mixed deafness was the most common at 12 months after radiotherapy. Compared with those before radiotherapy, the PL of V wave of BAEP was significantly prolonged (P <0.05), and the PL of Ⅰ, Ⅲ and V wave of BAEP at 6 months after the end of radiotherapy was significantly lower than that of I ~ Ⅲ, Ⅲ ~ Ⅴ, Ⅰ ~ Ⅴ IPL significantly prolonged (P <0.01). BAEP 8 cases of radiotherapy abnormalities, 12 months after radiotherapy increased to 23 cases. In the follow-up test found that some electrical audiometry and BAEP abnormalities improved, 3 to 6 months after radiotherapy, the highest rate of improvement. Conclusion The auditory access injury after radiotherapy of nasopharyngeal carcinoma may include the entire auditory access. Within 6 months after radiotherapy is the coexistence of injury and repair the most active period, should be the best period for the treatment of hearing impairment.