Abstract
High-dose radiation therapy for the treatment of head-and-neck tumors, including those of the central nervous system or acoustic schwannomas, can damage components of the auditory system.
Radiation-induced morbidities to all parts of the auditory system, including external, middle, and inner ear, can occur (e.g. external otitis, cochlear-associated hearing loss), and their incidence/severity is radiation dose-related (both total dose and fraction size).
Timing can be variable and be acute, chronic, and delayed.
The degree of morbidity varies from mild to severe; some are easily manageable while others are irreversible and require rehabilitation.
Chemotherapy can independently cause damage to the cochlea, and be additive to radiation-induced injury; evidence for synergism is lacking.
Controversy exists as to whether traditionally fractionated radiation therapy is safer than hypofractionated radiation therapy when used to treat vestibular schwannomas.