Abstract
Objective: To examine the possible role of intratympanic dexamethasone (ITD) in the prevention of cisplatinum-induced hearing loss in oncological patients receiving it in a cumulative dose greater than 300 mg as part of their treatment regimen.
Method: Eighteen patients were recruited since July 2011, to a prospective controlled cohort study. ITD was repeatedly delivered to one ear while the other served as the control immediately prior to each cisplatinum treatment. Audiometry and distortion-product oto-acoustic emissions (DPOAEs) parameters were compared between and within the study and control groups.
Results: Seven patients have received to date the minimal required cumulative dose of 300 mg cisplatinum, ranging from 345 to 888 mg (average of 527 + 155 mg). Pure-tone thresholds at 8000 Hz recorded at the last follow-up evaluation were significantly increased in both the study and control groups (P < .04). Also, marginally statistically significant increase in 4000-8000 Hz pure tone averages and decrease in the average DPOAEs SNR values at 4000-8000 Hz f2 frequencies were documented in both groups. The variance between the groups in any of the measured parameters in the last follow-up evaluation did not reach statistical significance.
Conclusion: Hearing loss mainly affecting the 8000 Hz region was found in patients receiving cisplatinum. DPOAEs evaluation demonstrated ototoxic effect to outer hair cell responding to the 4000-8000 Hz frequency range. We could not yet demonstrate any beneficial effect of ITD in the prevention of cisplatinum-induced hearing loss.
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