Treatment for nasopharyngeal cancer can affect your hearing. You might have difficulty hearing soft sounds, high pitched sounds or telling some sounds apart. Your doctor might refer you to a professional trained in hearing loss (an audiologist) if they think the hearing loss might be permanent.
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 via the auditory nerve, where the brain enables you to hear them as sound.
How can treatment affect your hearing?
Some treatment 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 for nasopharyngeal cancer cause swelling around the part of your middle ear that connects up to the back of your nose (the eustachian tube). This swelling can cause conductive hearing loss, which 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. Occasionally radiotherapy treatment can cause it. This may be permanent.
Chemotherapy and hearing
Some chemotherapy drugs can affect hearing. A drug called cisplatin can affect your ability to hear high pitched sounds. This usually gets better on its own after your treatment has finished.
Hearing problems can also be due to ear infections. If you have had radiotherapy for nasopharyngeal cancer, you are more likely to get an ear infection. 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, and possibly the use of a hearing aid. Or you might have a small tube (grommet) put in to drain the fluid. To put the grommet in you need a small operation.
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 or the radio 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 probably 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 particular needs.
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