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Multidisciplinary Team Role in Cochlear Implantation after Radiotherapy and Chemotherapy in Nasopharyngeal Carcinoma Patients
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  • Yue Liang,
  • Fanqin Wei,
  • Huiwen Zhuang,
  • Jincangjian Sun,
  • Liping Xie,
  • Kaitian Chen,
  • Guanxia Xiong
Yue Liang
Sun Yat-sen University First Affiliated Hospital

Corresponding Author:[email protected]

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Fanqin Wei
Sun Yat-sen University First Affiliated Hospital
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Huiwen Zhuang
Sun Yat-sen University First Affiliated Hospital
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Jincangjian Sun
Sun Yat-sen University First Affiliated Hospital
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Liping Xie
Sun Yat-sen University First Affiliated Hospital
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Kaitian Chen
Sun Yat-sen University First Affiliated Hospital
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Guanxia Xiong
Sun Yat-sen University First Affiliated Hospital
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Abstract

Objectives: To explore the role of multidisciplinary team (MDT) in perioperative safety and feasibility evaluation and postoperative effect prediction of cochlear implantation (CI) in patients with bilateral profound sensorineural hearing loss (SNHL) after radiotherapy and chemotherapy for nasopharyngeal carcinoma (NPC). Methods: From 2017 to 2022, 11 patients with bilateral profound SNHL after radiotherapy and chemotherapy for NPC received CI in our department. MDT formulated diagnosis and treatment plan for all patients during their perioperative period. The MDT participants were from the following departments: otorhinolaryngology, radiology, radiotherapy, neurology, psychiatry, anesthesiology, and audiology and speech rehabilitation. Several hearing examinations were tested during the follow-up to dynamically observe the effectiveness of the hearing and speech rehabilitation in the patients. Results: Based on the MDT conclusion and decision, five patients underwent routine CI, two patients underwent simultaneously extended radical mastoidectomy and CI, and four patients underwent simultaneously subtotal petrosectomy, external auditory canal elimination, mastoid cavity obliteration by fat graft or musculoperiosteal flaps and CI. The pure tone average of all 11 patients was 39.5 ± 5.0 dB and the average speech discrimination score was 95.0 ± 9.7% postoperatively. One patient underwent a second surgery for the cochlear electrode prolapsed postoperatively. Conclusion: To some extent, CI is risky for patients after chemoradiotherapy for NPC. However, the MDT approach can reduce the risk fast, predict the auditory effect after implantation early, as well as predict and prevent the occurrence of postoperative complications. Therefore, MDT exerts a positive effect on the outcome of the relatively safe and feasible application of CI in these patients. Keywords: Multidisciplinary team, nasopharyngeal carcinoma, cochlear implantation.