Detection of Early Ototoxic Effect in Testicular-Cancer Patients Treated with Cisplatin by Transiently Evoked Otoacoustic Emission: A Pilot Study

Abstract

The outlook for patients with testicular germ cell cancer was dramatically improved by the introduction of cisplatin. Well-known side effects of cisplatin (nausea, vomiting, nephrotoxicity, myelosuppression) can be managed with preventive methods. The long life expectancy after this therapy draws attention to long-term side effects. The ototoxic side effects were scarcely studied, although nowadays, they can be a dose-limiting side effect of cisplatin. Patients and Methods: As the literature shows, the ototoxic side effects of cisplatin have been studied mostly by conventional methods. The authors used transiently evoked otoacoustic emissions to determine whether the administration of 20 mg/m² body surface cisplatin daily (in combination with other antitumor drugs) for 5 days alters the amplitude of the transient oto-acoustic emission. Results: The results did not show any significant amplitude change after 20 mg/m² cisplatin daily for 5 days, in contrast with other studies that described a broad frequency reduction of the emission amplitude in 30-86% of cases treated with 100 mg/m² of cisplatin for 1 day. Conclusion: The authors suggest that between similarly effective regimens, those containing lower daily cisplatin doses should be used.

Characteristics and Risk Factors of Cisplatin-Induced Ototoxicity in Testicular Cancer Patients Detected by Distorsion Product Otoacoustic Emission

“…The first sign of auditory impairment usually appears 3–4 days after initial cisplatin treatment (range: 15–65 dB). In a previous study, we have shown that schedules containing daily low-dose cisplatin are less ototoxic than those containing higher daily doses [10]. This was in accordance with the findings of other studies [11,12,13].…”

Otoacoustic Emissions for Monitoring Aminoglycoside-Induced Ototoxicity in Children With Cystic Fibrosis

“…10 It is now well established that OAEs measures are more sensitive to inner ear dysfunction than conventional PTA or auditory brainstem responses. 7,12,25 In our study, both TE and DP OAEs were significantly affected at the higher frequencies following recent gentamicin exposure. Decreased emissions in the presence of normal behavioral hearing may indicate an underlying pathologic condition, which, if allowed to continue, might result in a clinically significant hearing loss.…”

Repeatability of High-Frequency Distortion-Product Otoacoustic Emissions in Normal-Hearing Adults

“…Recent reports have examined the feasibility of using DPOAE measures to assess and monitor patients exposed to noise and ototoxic drug treatments (Biro, Baki, Buki et al, 1997;Hall & Lutman, 1999;Mulheran & Degg, 1997;Ress, Sridhar, Balkany et al, 1999;Stavroulaki, Nikolopoulos, Psarommatis et al, 2001;Stavroulaki, Vossinakis, Dinopoulou et al, 2002). Stavroulaki, Nikolopoulos, Psarommatis et al (2001) found that hearing loss predominantly occurred at high frequencies (especially 12 kHz) for young patients with chronic renal failure having hemodialysis and that DPOAE levels were decreased whether patients did or did not have hearing loss up to 4 kHz versus age-matched controls.…”