Author(s): Sudeep Madisetti1
BACKGROUND Ototoxicity is defined as the pharmacological adverse reaction affecting the inner ear or auditory nerve, characterized by cochlear or vestibular dysfunction. Cisplatin used most frequently in the treatment of malignancies is an ototoxic agent. Evidence has shown that early detection of toxicity through prospective ototoxicity monitoring allows for consideration of treatment modifications to minimize or prevent permanent hearing loss and balance impairment. We wanted to conduct audiological evaluation of patients on chemotherapy with Cisplatin to evaluate the development of hearing loss and report. METHODS A retrospective study was conducted over a period of 3 years. All patients were subjected to thorough ENT examination, audiological evaluation including air and bone thresholds, pure tone average, speech discrimination and DPOAE. In addition, complete haemogram, liver and renal function tests were performed to evaluate the fitness for chemotherapy. Serial audiograms are taken at the end of each cycle up to 06 cycles of chemotherapy. Follow-up audiograms are taken at 03 months and 06 months after completion of chemotherapy. RESULTS Audiological evaluation among the 72 patients before the commencement of chemotherapy showed that 52 patients had normal hearing with air thresholds ranging from 10 to 20 dB with a mean of 14.45 ± 1.05 dB, bone thresholds ranging from 05 to 10 dB with a mean of 09.45 ± 0.35 dB. The pure tone average was ranging from 15 to 20 dB with a mean of 17.15 ± 1.75 dB. The speech discrimination score was 80 to 85%. The DPOAE values were present and normal in all the patients (100%). Among the 52 patients with normal hearing 07/52 (13.46%) had developed moderate hearing loss and among the 20 patients with pre-existing hearing loss, 04 / 20 (20%) patients had developed severe sensorineural hearing loss in this study. CONCLUSIONS Among the 52 patients with normal hearing 07 / 52 (13.46%) had developed moderate hearing loss and among the 20 patients with pre-existing hearing loss, 04 / 20 (20%) patients had developed severe sensorineural hearing loss in this study. Hence audiologic monitoring is important in patients undergoing Cisplatin chemotherapy and post-chemotherapy auditory monitoring is essential to rehabilitate the patients with sensorineural hearing loss.