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        Hearing impairment among Nasopharyngeal Cancer (NPC) survivors
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        Hearing impairment among Nasopharyngeal Cancer (NPC) survivors
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Learning Objectives: To evaluate hearing impairment and other otological symptoms in NPC survivors To evaluate hearing aid usage in this population of patients.

Introduction: As the treatment outcome for nasopharyngeal cancer (NPC) patients continues to improve, there is an increasing pool of survivors. The treatment is not without its costs and many survivors suffer from hearing impairment that can lead to deterioration in quality of life. Hearing aids may help but uptake is generally low. We seek to investigate hearing and ear problems as well as acceptance of hearing aids among NPC survivors.

Methods: A cross-sectional survey was conducted among 35 NPC survivors who attended 2 NPC educational talks.

Results: Among the 35 patients recruited, 77% have hearing problems with 5 having both ears affected. The mean duration to onset of hearing loss post treatment is 3.08 years. Treatment modality (Chemoradiotherapy vs Radiotherapy only) did not affect prevalence and degree of hearing loss. Among those with self-reported hearing problems, 43% thinks that the hearing loss is moderate to severe, and more than 50% feels that it has caused them disability; a common reason cited was difficulty in communication. However, only 30% of patients are currently using hearing aids. Severity of hearing loss and hearing aid usage were correlated with r = 8.563, p-value = 0.003. Interestingly, 47% of the patients with hearing problems were never offered hearing aids during the follow-ups. Among those who are currently wearing hearing aids, only 63% wear it for more than 8 hours per day. Besides hearing impairment, 14% have recurrent ear infections and 26% needs to have their ears cleaned regularly. 87% of the patients suffers from other otological symptoms, the most common being tinnitus and sensation of blocked ears.

Conclusion: Hearing impairment is a common problem, causing significant disability among NPC survivors. However, usage of hearing aids is low. Our results suggest that beyond the surveillance of cancer recurrence, physicians should take an active role in assessing patient's hearing impairment and suitability of hearing aids.