From the Guidelines
Radiation therapy for squamous cell carcinoma of the tongue can cause tinnitus, particularly when the treatment field includes or is in close proximity to the ears, temporal bones, or auditory nerve pathways, with higher radiation doses increasing the risk 1. When radiation fields include or are in close proximity to the ears, temporal bones, or auditory nerve pathways, patients may experience tinnitus (ringing or buzzing in the ears) as a side effect. This occurs because radiation can damage the delicate hair cells in the inner ear, affect blood flow to auditory structures, or cause inflammation that disrupts normal hearing function. The risk of tinnitus is increased in patients treated with moderate-dose to high-dose head or brain radiotherapy (≥30 Gy) 1. Key points to consider include:
- Tinnitus may develop during treatment or appear months after completion of radiation therapy
- Patients undergoing radiation for tongue cancer should be informed about this potential side effect and encouraged to report any hearing changes or tinnitus to their healthcare provider promptly
- Management options include audiological evaluation, sound therapy, or medications to help manage the symptoms if they develop 1. It is essential to note that the evidence base for radiation therapy in oropharyngeal squamous cell carcinoma is still developing, and more specific recommendations may be possible in the future with continued accrual to clinical trials 2.
From the Research
Radiation Therapy and Tinnitus
- There is no direct evidence in the provided studies that links radiation therapy for squamous cell carcinoma of the tongue to tinnitus (ringing in the ears) 3, 4, 5, 6, 7.
- The studies focus on the treatment outcomes of squamous cell carcinoma of the tongue, including surgery, radiation therapy, and combined treatment modalities, but do not mention tinnitus as a side effect 3, 4, 5, 6, 7.
- One study mentions a rare complication of radiation therapy, lingual Raynaud's phenomenon, which involves pallor and discomfort on exposure to cold temperatures, but does not mention tinnitus 6.
- Another study discusses the evolution of treatment modalities and radiation techniques for base-of-tongue carcinoma, but does not mention tinnitus as a side effect 7.
Treatment Outcomes
- The studies suggest that radiation therapy can be an effective treatment for squamous cell carcinoma of the tongue, with comparable outcomes to surgery in some cases 4, 5.
- The choice of treatment modality and radiation technique can affect treatment outcomes, with some studies suggesting that definitive chemoradiotherapy and intensity-modulated radiation therapy (IMRT) may improve locoregional control and overall survival 5, 7.