[Delayed damage of ionizing radiation on the inner ear].

To investigate the feature and mechanism of delayed effect of ionizing radiation on the inner ear, the function and structure of the inner ear of the guinea pigs were observed during 8 month's period after exposure to fractional doses of gamma radiation (2 Gy per day) with a total dose of 60 Gy. Morphological study was performed using light microscopy, transmission and scanning electron microscopy while the function was measured with electrocochleography (ECochG) and electronystagmography (ENG). The results showed that the mean CAP response threshold was 35.67 +/- 6.78 dB before radiation, and 41.17 +/- 7.76 dB, 47.00 +/- 8.82 dB and 71.00 +/- 7.63 dB at 1st day, 3rd month and 8th months after completion of treatment, respectively. No significant change was demonstrated in the auditory responses at the 1st day of radiation (P > 0.05), but there was obvious hearing loss at 3rd and 8th month (P < 0.01). The nystagmus duration induced by ice water (ENG) was 40.00 +/- 5.44 seconds before radiation, 22.71 +/- 7.93 seconds at 8th month after radiation (P < 0.01). Histologic examination at 8th month after radiation revealed atrophy and degeneration of stria vascularis, a reduced number of capillaries, degeneration of endotheliocyte in vessels, outer hair cell and supporting cell of Corti's organ. The percentage of damaged hair cells in basal turn of the cochlea was significantly higher than those of the upper turn. Degeneration of vestibular hair cell was found. It is suggested that radiation from routine radiotherapy doses may result in a delayed impairment of the inner ear. The main mechanism of the radiation damage may be interference of oxygen supply and metabolism of the inner ear by radiation vascular lesion.