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Radiation Effects on the Ear and Temporal Bone
Built from Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
What’s inside
8 sections · 100 slides
Overview
- Scope of the problem
- Structure of this account
Radiation fundamentals
- Biophysical basis of radiotherapy
- Direct and indirect DNA damage
- Modalities of radiation delivery
- Fractionation and specialised techniques
Radiation effects on tissues
- Dose dependence of tissue injury
- Vascular changes after radiotherapy
- Radiation effects on bone
- Why the temporal bone is vulnerable
- Marx 3-H theory of osteoradionecrosis
- Delanian and Lefaix fibroatrophic theory
- Time course of radiation effects
Outer ear and ear canal
- Acute effects on the outer ear
- Skin care during radiotherapy
- Outer ear changes during and after radiotherapy
- Exposed helical cartilage after chemoradiotherapy
- Debris and cleaning of the irradiated canal
- Loss of hair follicles and ceruminous glands
- Keratin plug in the irradiated ear canal
- Canal stenosis and anterior sulcus scarring
- Effaced drum and anterior sulcus scar band
- Baseline and post-treatment CT of the thickened drum
- Completely effaced drum after parotid radiotherapy
- Isodose lines and audiogram after parotid radiotherapy
- Rehabilitation of radiation conductive loss
Middle ear
- Pathogenesis of radiation otitis media
- Incidence and dose relationship
- Serous otitis media after proton therapy
- Management of radiation otitis media
- Chronic post-radiation otorrhoea
- Pressure equalising tubes in the irradiated ear
- Persistent dry perforation after chemoradiotherapy
- Intruded ventilation tube in the middle ear
- Ossicular chain loss after temporal bone radiation
- Outcomes of tympanoplasty in irradiated ears
- Tympanomastoidectomy in the irradiated ear
- Results of tympanomastoidectomy in irradiated ears
- Osseointegrated hearing aids after treatment
Inner ear
- Radiation sensorineural hearing loss
- Defining a significant hearing change
- Common terminology for criteria for adverse events , version 4, ear and hearing
- Common terminology for criteria for adverse events, version 4, ear and hearing (continued)
- Reported incidence of hearing loss
- Cochlear histopathology after irradiation
- Basal turn injury and high frequency loss
- Mechanisms of cochlear cell death
- Explaining the long latent period
- Hearing loss in irradiated children
- Longitudinal and proton beam data
- Progression with chemoradiotherapy
- Cochlear dose thresholds
- Hearing loss in nasopharyngeal carcinoma
- Sudden sensorineural hearing loss after radiotherapy
- Vestibular effects of temporal bone radiation
Osteoradionecrosis
- Symptoms of temporal bone osteoradionecrosis
- Reported incidence of osteoradionecrosis
- Pathology of osteoradionecrosis
- Localized and diffuse osteoradionecrosis
- Localized exposed bone in the ear canal
- CT findings in osteoradionecrosis
- Conservative management of localized disease
- Sequestrectomy of exposed canal bone
- Flap reconstruction of the irradiated canal
- Diffuse osteoradionecrosis of the temporal bone
- Surgery for diffuse osteoradionecrosis
- Canal wall erosion progressing to canal fistula
- MD Anderson series of temporal bone ORN
- Disease distribution and outcomes at MD Anderson
- Other published ORN series
- Hyperbaric oxygen in osteoradionecrosis
- Medical protocols for osteoradionecrosis
- PENTOCLO protocol for jaw ORN
- PENTOCLO protocol for jaw ORN (continued)
Vascular, cerebral and neoplastic complications
- Postradiation lateral sinus thrombosis
- Sentinel bleeding and carotid artery rupture
- Exposed canal bone and carotid coiling
- Temporal lobe necrosis
- Criteria for radiation-associated malignancy
- Histology of temporal bone radiation-associated tumours
- Presentation and differential diagnosis
- Dose relationship and latency of secondary tumours
- Staging and treatment of ear canal malignancy
- Principles of care in the irradiated ear
- Key numbers to carry forward
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
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