Voice and Hearing Outcomes in Nasopharyngeal Cancer Survivors: A Cross-Sectional Evaluation

Introduction: The study aims to evaluate and compare the voice and hearing outcomes in nasopharyngeal cancer survivors treated with radiotherapy (RT) or chemoradiotherapy with a healthy control group.
Methods: This cross-sectional study recruited 21 patients with a history of nasopharyngeal carcinoma (NPC) who received RT or chemoradiotherapy and 19 control subjects matched for age. Voice evaluation was performed using perceptual and acoustic measures, and hearing function was assessed using pure tone audiometry.
Results: The NPC group exhibited significantly poorer voice quality, as indicated by higher perceptual scores (GRBAS scale), higher self-reported voice handicap (voice handicap index - 10 scale), and increased frequency perturbation (%jitter) compared to the control group. Significant differences were also observed in other acoustic parameters, including fundamental frequency, amplitude perturbation (% shimmer), and noise-to-harmonic ratio. Hearing loss was more prevalent in the nasopharyngeal cancer group, particularly at high frequencies. Some correlations were observed between certain acoustic voice parameters and hearing thresholds, particularly in the nasopharyngeal cancer group. However, a consistent pattern across all parameters was not evident.
Discussion and Conclusion: Nasopharyngeal cancer survivors treated with RT or chemoradiotherapy experience significant voice and hearing impairments compared to healthy controls. These findings highlight the importance of routine voice and hearing evaluations for this patient population.

Keywords: Cancer; Hearing; Nasopharynx; Radiotherapy; Voice