Hearing after nasopharyngeal cancer treatment

Treatment for nasopharyngeal cancer can affect your hearing. You might develop ringing in your ears (tinnitus), or have difficulty hearing soft or high pitched sounds, or telling some sounds apart. You usually have hearing tests before, during and after treatment.

How does your sense of hearing work?

Every sound disturbs the air around it, causing vibrations that travel through the air as sound waves. Your outer ear picks up these vibrations and directs them towards the inner part of your ear.

These vibrations are then converted to nerve impulses. The impulses travel to the brain by the auditory nerve. The brain interprets these impulses as sound.

How can treatment affect your hearing?

Some treatments for nasopharyngeal cancer might affect your hearing.

Conductive hearing loss

Your treatment might disrupt the way the ear directs sound. This is called conductive hearing loss.

Some types of surgery and radiotherapy cause swelling around the part of your middle ear that connects to the back of your nose - the eustachian tube. This makes it difficult to hear soft sounds. Your hearing usually gets back to normal once the swelling goes down.

Sensorineural hearing loss

Your hearing might change because of damage to the sensory cells of your ear and nerves. These cells send messages to the brain.

This type of hearing change makes it difficult to hear soft sounds, and also to tell some sounds apart. It is called sensorineural hearing loss. Radiotherapy treatment can cause it. This may be permanent for some people.

Chemotherapy and hearing

Some chemotherapy drugs can affect hearing. You usually have a chemotherapy drug called cisplatin to treat nasopharyngeal cancer. Cisplatin can affect your ability to hear high pitched sounds. This usually gets better on its own after your treatment has finished.

Ear infections

Hearing problems can also be due to ear infections. You are more likely to get an ear infection if you have had radiotherapy for nasopharyngeal cancer. The middle ear becomes inflamed and can fill with fluid.

There are different ways to treat this type of ear infection. Your doctor might suggest treatment with drugs to reduce the infection and inflammation. They may drain the fluid. And you may use a hearing aid.

Coping with hearing loss

Although usually temporary, hearing problems can be hard to cope with. It affects many of your daily activities. It becomes harder to have face to face or telephone conversations. Ways of relaxing such as listening to music and watching TV may be more difficult or less enjoyable. You may get fed up with asking people to repeat things. This can be a worry when talking to your doctors, as you may be concerned that you are missing vital bits of information.

It is important to tell people that your hearing is not so good. They can then speak a little louder, and more clearly. They may also need to face you when speaking as this often helps. Try to get rid of background noise, such as the TV or radio, when talking to people. Ask them to turn the noise down, and explain why you’re asking.

If your hearing loss is likely to be permanent your doctor will refer you to an audiologist. This is a professional trained in hearing loss. An audiologist will look at the degree of hearing loss you have. And they can provide further treatment and help, to best suit your own needs.

Cancer Chat

Cancer Chat is our free online discussion forum for people affected by cancer. It is a safe space to talk to other people in similar situations, and find information and support.

Cancer Research UK nurses

For support and information, you can call the Cancer Research UK information nurses. They can give advice about who can help you and what kind of support is available. Freephone: 0808 800 4040 - Monday to Friday, 9am to 5pm.
  • Ross and Wilson Anatomy and Physiology in Health and Illness (13th edition)
    A Waugh and A Grant
    Elsevier, 2018

  • Nasopharyngeal carcinoma: United Kingdom National Multidisciplinary Guidelines
    R Simo and others
    The Journal of Laryngology and Otology, 2016. Volume 130, Supplement 2, Pages 97-103

  • Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow up
    P Bossi and others
    Annals of Oncology, 2021. Volume 32, Issue 4, Page 452-465

  • Management of late complications of head and neck cancer and its treatment
    UpToDate website
    Accessed November 2021

Last reviewed: 
25 Nov 2021
Next review due: 
25 Nov 2024

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