Radiotherapy either primary or adjuvant, is a commonly used modality of treatment in head and neck malignancies. The audiovestibular apparatus is often within the fields of radiation treatment, and hearing loss is a possible complication. This study was undertaken to assess the audiovestibular functions in patients undergoing radiation therapy for head and neck malignancies to determine the type and severity of hearing loss and vestibular dysfunction following radiation therapy.

Fifty patients with head and neck malignancies reported to the malignant disease treatment center of INHS Asvini and received radiotherapy as a primary modality of treatment or in combination with surgery during the period May 2003 to Sep 2004 were included in this study. None of these patients had prior treatment by chemotherapy.

A significant number of patients who were subjected to radiation therapy for head and neck malignancies develop conductive hearing loss is predominant in the immediate postradiation period. Conductive hearing loss is reversible and improves with the conservative line of treatment. Sensorineural hearing loss more commonly affects the higher frequencies and is more common in older patients. Sensorineural hearing loss is more common when radiation doses exceed 60 Gy. There is no conclusive evidence of vestibular dysfunction in patients undergoing radiotherapy for head and neck cancers.

Arachnoid cysts constitute 1% of all intracranial space-occupying lesions. These typically produce vague and nonspecific symptoms. However, a subset of these lesions can produce constellation of signs and symptoms indistinguishable from those causing peripheral vertigo. We discuss the presentation of a giant arachnoid cyst which presented with dizziness and mimicked benign paroxysmal vertigo of childhood (BPVC).

Trauma is one of the commonest causes of perilymphatic fistulae. The classical patient presents with a sudden onset vertigo, tinnitus and hearing loss, which may be fluctuating. The audiological changes can range from a purely conductive hearing loss, to mixed hearing losses (most common) to sensorineural hearing loss. The same are dependent on a number of factors, such as extent of trauma and perilymphatic leak, the presence of superadded infection, the tardiness in obtaining appropriate treatment, etc.

A case of post-traumatic perilymphatic fistula has been presented here, and discussed with regards to the presentation, clinical diagnosis, treatment and the audiological profile and eventual outcome.

The audiological profile of a patient should be carefully correlated with the CT scan findings, the clinical picture as well as the intraoperative findings so as to predict and understand the eventual audiological outcome after treatment.

dB: decibels, Hz: Hertz, KHz: Kilo hertz, BPPV: benign paroxysmal positional vertigo, Deg: degrees.