Changes in your hearing

Nasopharyngeal cancer and its treatment can cause changes to your hearing and hearing loss. 

You might:

• develop ringing in your ears (tinnitus)

• have difficulty hearing soft or high pitched sounds

• have difficulty telling some sounds apart

You might have hearing tests before, during, and after treatment. Speak to your nurse or doctor if you notice changes to your hearing. They can refer you to a hearing specialist.

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 by the auditory nerve. The brain interprets these impulses as sound.

Treatments that can affect your hearing

Sometimes, treatments for nasopharyngeal cancer may affect your hearing.

Conductive hearing loss

Conductive hearing loss can happen when something blocks noise from the outer to the middle ear. This stops sound from getting through properly.

Some types of surgery and radiotherapy for nasopharyngeal cancer can cause swelling in the middle ear. The swelling can be due to a build up of fluid. This can cause conductive hearing loss. This problem usually improves, but can sometimes persist.  

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 problem can be caused by radiotherapy treatment. Hearing loss or changes can happen during or soon after treatment. Some people might experience hearing loss a few months or a few years after treatment.

Unfortunately, this type of hearing loss can be permanent.

Your doctor will tell you if there is a chance that your hearing might be affected.

Chemotherapy and hearing changes 

Some chemotherapy drugs can affect hearing. A chemotherapy drug called cisplatin is commonly used to treat nasopharyngeal cancer. Cisplatin can affect your ability to hear high pitched sounds. Usually, this is a temporary problem that happens during your treatment and recovery. But occasionally hearing loss or changes can be permanent. 

Ear infections

Hearing problems can also be due to ear infections. You are more likely to get an ear infection if you have had radiotherapy for nasopharyngeal cancer. 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. 

Coping with hearing loss

Although usually temporary, hearing problems can be hard to cope with. Many of your daily activities are affected.

It becomes harder to have face to face or telephone conversations. Ways of relaxing, such as listening to music or watching TV, may be more difficult or less enjoyable. You may get frustrated asking people to repeat things.

This can be a worry when talking to your doctors. You may be concerned that you are missing vital bits of information.

When talking to people, it is important that you:

• tell them your hearing is not so good

• ask them to speak a little louder and more clearly

• explain they may need to face you when speaking, as this often helps

• turn off or remove background noise, such as the TV or radio - ask them to turn the noise down and explain why

If your hearing loss is likely to be permanent, your doctor will probably refer you to an audiologist. They look at the degree of hearing loss you have. And they can give you treatment suited to your own particular needs.

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Cancer Research UK nurses