INTRODUCTION
Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor that
originates from the nasopharynx, which is highly prevalent in East and
Southeast Asia, especially in South China.1Intensity-modulated radiotherapy (IMRT) alone or in combination with
chemotherapy is recommended for the treatment of NPC.2In the course of treatments, the hearing apparatus, including the
tympanic membrane, eustachian tube, and cochlea are damaged by radiation
and the adjuvant chemotherapy drugs. Hearing loss was reported was a
major adverse effect of the treatment of an NPC
patient.3 Hearing loss seriously and negatively
affects patients’ daily communication and quality of life, further
leading to a decline in patients’ cognitive function. In contrast to the
insufficient compensation effect of hearing aids (HA), cochlear
implantation (CI) is an effective method for the recovery of the hearing
of patients suffering from severe to profound SNHL.4,5
However, long-term complications after chemoradiotherapy, including
limitation of the mouth opening, caused by temporomandibular joint
dysfunction, neck fibrosis, osteoradionecrosis of the temporal bone
(ORNTB), chronic otitis media, eustachian tube dysfunction, radioactive
encephalopathy (REP), and radioactive paranasal sinusitis affect
perioperative safety and surgical feasibility.6,7Although previous evidence has shown that CI can significantly improve
the hearing of patients with severe or profound SNHL after
chemoradiotherapy for NPC, the perioperative safety and feasibility, as
well as surgical effect of CI remain key issues.8Therefore, we propose the introduction of the multidisciplinary team
(MDT) discussion approach of the above issues.
MDT is a clinical treatment mode in which experts from different
specialties form relatively fixed expert groups that regularly schedule
discussion concerning the diagnosis and treatment for a certain organ or
system disease. Currently, MDT is widely implemented in the field of
malignant tumor therapy.9 In our department, MDT is
often used in the comprehensive treatment of head and neck tumors.
Experts from various departments jointly evaluate and plan interventions
of specific patients. Hence, optimal treatment plans are assigned to
patients according to the particular clinical needs.
In this study, we applied MDT to the whole process, including the
perioperative and postoperative period. Our study showed that the role
of MDT in CI after chemoradiotherapy of NPC patients is of considerable
significance.