الفهرس 
Anatomy of Middle Ear cleftOnly 14 pages are availabe for public view
 |  | from | 80 |  |  |
| | | from | 80 | | |
Abstract
This study was conducted on 30 patients (60) ears. Who were selected
from otorhinolaryngology outpatient clinics, menofia University, maadi military
hospital air forces specialized hospital from February 2019 to February 2020.
Patients suffering from neck squamous cell carcinoma (SCC) and
subjected to radiotherapy (either as primary radiotherapy alone, or combined
postoperative or concomitant with chemoradioherapy) were included in our study.
Carcinomas of nasopharynx was excluded from the study. Patients were subjected
to careful history taking and full otolaryngological and head and neck
examination. Audiological evaluation was performed using acoustic emittance
measurement including tympanometry and stapedius acoustic reflex ipsilateral
and contralateral before, after and 12 weeks post radiotherapy
Statistical analysis using Pearson chie square 2 weeks post radiotherapy
revealed that 63.3% of the patients developed abnormal tympanometry findings
which were 26.6% as type B tympanogram and 36.7% as type C tympanogram the
acoustic reflex test results in this study revealed that 86.7% of the ears (p=0.04)
had an absent acoustic reflex. Twelve weeks later tympanometry reveled
significant increase in contralateral ET dysfunction at end of ttt (20%) and 12-
weeks follow up (10%); with significant difference (p = 0.011). Comparative
study between baseline, end of ttt and 12-weeks tympanograms revealed; highly
significant increase in ipsilateral ET dysfunction at end of ttt (33.3%) and 12-
weeks follow up (20%); with highly significant difference (p = 0.001).
In our study we were concerned with relation of tumor site and its relation
to ETD occurred due to exposure to radiotherapy we found that the site of the
tumor has a significant element (as the glottic tumors have less grading and less
radiation exposure which mean decreasing the post RT percentage of ETD due to
early presentation with hoarseness of voice and low N grading).
from this study we concluded that Patients with head and neck tumors
treated by radiotherapy (apart from the nasopharynx) have a high incidence of
affection of Eustachian tube function namely middle ear effusion and Eustachian
tube dysfunction. The possibility for development of middle ear effusion and
Eustachian tube dysfunction increases with increased tumor stage. Tumor site has
significant difference at Eustachian tube affection immediately post radiotherapy
and after 12 of the end of radiotherapy. The Eustachian tube functions significally
improve within 12 weeks after the last dose of radiotherapy. We recommend
audiological follow up for patients treated with radiotherapy.