Tinnitus in the treatment of head and neck cancer

Tinnitus is a medical term, is a condition where the patient can only hear sounds in the ear but not outside sounds. This in-ear sound is often described as ringing, or hissing in the ear. You can interpret that sound as “tinnitus”.
Tinnitus may not change or occur frequently. Sound can be heard in one or both ears.
Tinnitus is the perception of sounds in the head or ears. The term tinnitus comes from the Latin tinnire, which means ringing. Normally, an individual perceives sound when there is no external sound. Sounds that only the patient can hear is subjective tinnitus, while sounds that others can also hear are called objective tinnitus.
Tinnitus is a symptom (not a disease) and therefore reflects an underlying abnormality in the patient's health. Usually, tinnitus is associated with sensorineural hearing loss, but other types of tinnitus include vibrating tinnitus, vertigo tinnitus, fluctuating tinnitus, or unilateral tinnitus.
On the other hand, tinnitus can be a possible side effect of cancer treatment due to certain drugs used in chemotherapy or radiation therapy for cancer patients, for example. such as: cisplatin, carboplatin, meclorethamine and vincristine. Tinnitus may be temporary or permanent, depending on the dose of medication received.
Tinnitus can also be related to some degree of hearing loss. Radiation therapy for head and neck cancer can cause hearing loss or make drug-induced ototoxicity worse.

2.1. What is head and neck cancer? Cancers collectively known as head and neck cancers usually start in the squamous cells that line the lining surfaces of the head and neck (for example, those inside the mouth, throat, and skull). These cancers are called squamous cell carcinomas of the head and neck. Head and neck cancers can also start in the salivary glands, sinuses, muscles, or nerves of the head and neck, but these cancers are much less common than squamous cell cancers.
Cancer of the head and neck can form in:
Oral cavity : Includes lips, front 2/3 of tongue, gums, inner lining of cheeks and lips, floor (bottom) of mouth under tongue, hard palate (the bone at the top of the mouth), and the small gum area behind the wisdom teeth. Pharynx (pharynx): The pharynx is a hollow tube about 5 inches long that begins behind the nose and leads to the esophagus. It has three parts: the nasopharynx (the upper part of the pharynx, behind the nose); oropharynx (the middle part of the pharynx, including the soft palate [back of the mouth], the base of the tongue, and the tonsils); hypopharynx (lower part of pharynx). Voice box (larynx): The voice box is a short passage made of cartilage just below the pharynx in the neck. The dialog box contains the vocal cords. It also has a small piece of tissue, called the epiglottis, that moves to cover the voice box to prevent food from entering the airway. Paranasal sinuses and nasal cavity: The paranasal sinuses are small hollow spaces in the bones of the head that surround the nose. The nasal cavity is the hollow space inside the nose. Salivary Glands: The main salivary glands are located on the floor of the mouth and near the jawbone. Salivary glands produce saliva. Small salivary glands are located throughout the mucous membranes of the mouth and throat. 2.2. Some Risk Factors for Ear Tumors in Head and Neck Cancer Alcohol and tobacco use (including secondhand smoke and smokeless tobacco, sometimes called “chewing tobacco” or “snuff”) are two most important risk factor for head and neck cancer, especially cancers of the oral cavity, pharynx, and skull. People who use both tobacco and alcohol have a higher risk of developing these cancers than those who use only tobacco or alcohol. Most squamous cell carcinomas of the head and neck of the mouth and skull are caused by tobacco and alcohol use.
Infection with cancer-causing human papillomavirus (HPV), particularly HPV type 16, is a risk factor for oropharyngeal cancer involving the tonsils or the base of the tongue. In the United States, the incidence of oropharyngeal cancer due to HPV infection is increasing, while the incidence of oropharyngeal cancer related to other causes is decreasing. About three-quarters of oropharyngeal cancers are caused by chronic HPV infection. Although HPV can be detected in other head and neck cancers, it seems to be the only cause of cancer in the oropharynx. The reasons for this are not well understood.
Other known risk factors for specific cancers of the head and neck include:
Paan. The use of betel nut (betel nut) in the mouth, a common practice in Southeast Asia, is strongly associated with an increased risk of oral cancer. Occupational exposure. Occupational exposure to wood dust is a risk factor for oropharyngeal cancer. Some industrial exposures, including exposure to asbestos and synthetic fibers, have been linked to cancer of the voice box, but the increased risk remains controversial.) People who work in certain jobs in the construction, metalworking, textile, ceramics, logging, and food industries may have an increased risk of laryngeal cancer. Industrial exposure to wood dust, nickel dust or formaldehyde is a risk factor for cancer of the paranasal sinuses and nasal cavity. Exposure to radiation. Radiation to the head and neck, for noncancerous or cancerous conditions, is a risk factor for salivary gland cancer. Epstein-Barr virus infection. Epstein-Barr virus infection is a risk factor for nasopharyngeal and salivary gland cancers. Genetic. Asians, especially Chinese, have genetic risk factors for oropharyngeal cancer. Basic genetic disorder. Some genetic disorders, such as Fanconi anemia, can increase the risk of developing precancerous lesions and cancers early in life.

Every patient with symptoms of tinnitus should have a complete audiometric examination with speech, airborne, bone, and acoustic distinctions. Both these levels should match the intensity and volume being assessed. A minimum level of occlusion should also be achieved if treatment with transparal devices is being considered.
Blood tests for syphilis (absorbed fluorescent treponemal antibodies [FTA-ABS]), complete blood count (CBC), autoimmune panel (antinuclear antibodies [ANAs], speed erythrocyte sedimentation rate, rheumatoid factor) and thyroid function tests for useful hypermetabolism.
Imaging studies include the following:
Magnetic resonance imaging (MRI) - In pulsating tinnitus, it may be necessary to look for adrenal tumors, arterial malformations, vascular anomalies, dural artery fistula and carotid aneurysm in the ear; For asymmetric hearing loss or unilateral tinnitus, an internal auditory canal MRI is indicated to look for acoustic tumors Computed tomography (CT) - Will identify a sigmoid sac or osteonecrosis on a cylindrical light bulb Control of tinnitus in the treatment of head and neck cancer:
Tinnitus treatments, including the following, have had varying success:
Electrical stimulation Biofeedback Repetitive Transcranial Magnetic Stimulation Neuromonics Counseling Support Groups Pharmacological Therapy Tinnitus Mask Hearing Aid Retraining Tinnitus Feedback Although most tinnitus is not a surgical disease, tinnitus is Ear caused by a surgical injury to the ear usually responds to treatment for that injury. Typical operable lesions include those caused by glomus tumors, sigmoid diverticulum, arterial malformations, and conductive hearing loss.

4.1. Rehabilitation for people with head and neck cancer The aim of head and neck cancer treatment is to control the disease. But doctors are also interested in preserving the function of the affected areas as much as possible and helping patients return to normal activities as soon as possible after treatment.
Rehabilitation is a very important part of this process. The goals of rehabilitation depend on the extent of the disease and the treatment the patient has received.
Depending on the location of the cancer and the type of treatment, rehabilitation may include physical therapy, dietary counseling, speech therapy, and learning how to care for a tumor. The trachea is an opening into the windpipe through which a patient can breathe after a laryngectomy, which is surgery to remove the larynx.
4.2. Follow-up care for patients with tinnitus during cancer treatment Regular follow-up care is important after treatment for head and neck cancer to ensure that the cancer does not return and a second primary cancer ( new) does not grow.
Head and neck cancers unrelated to HPV infection are particularly likely to recur after treatment. Depending on the type of cancer, the medical examination may include examining the tumor, if a tumor has been created, and the mouth, neck, and throat. Regular dental visits may also be essential.
Occasionally, a doctor may perform a complete physical exam, blood tests, X-rays and computed tomography (CT) scans, positron emission tomography (PET) or magnetic resonance imaging (MRI) scans. ). Your doctor may monitor your thyroid and pituitary gland function, especially if the head or neck area is treated with radiation. In addition, the doctor will probably advise the patient to stop smoking. Research has shown that continued smoking by patients with head and neck cancer can reduce the effectiveness of treatment and increase the likelihood of a second primary cancer.
Currently, Vinmec International General Hospital has applied radiation therapy to patients with head and neck squamous cell carcinoma. Initial results are positive and many patients are elderly but well tolerated. Depending on the location of the lesion, it will be combined with local and regional thermogenic therapy.
Oncology Department at Vinmec is fully equipped with cancer treatment modalities: From surgery, radiation therapy, chemotherapy, radiosurgery to pain treatment and palliative care. The diagnosis is made carefully: blood test, X-ray, ultrasound, magnetic resonance imaging, myelogram, myelogram, biopsy, immunohistochemistry, biological diagnosis molecule.
The treatment process is closely coordinated with many specialties: Center for Diagnostic Imaging, Laboratory Testing, Cardiology, Department of Obstetrics and Gynecology, Department of Endocrinology, Department of Rehabilitation, Department of Psychology, Department of Medicine. Nutrition, Pain Treatment and Palliative Care Department, in order to bring patients the optimal treatment regimen and the most reasonable cost.