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.