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Updated: Aug 7, 2026
Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
Ototoxic impact of cisplatin in pediatric oncology patients
A L Berg1, J B Spitzer, J H Garvin
1Department of Speech Communication Sciences, Pace University, New York Presbyterian Hospital, and Columbia University College of Physicians and Surgeons, New York 10038-1598, USA.
Insights
Cisplatin chemotherapy can cause sensorineural hearing loss in children, regardless of dosage. Regular hearing tests are crucial after treatment to detect and manage potential hearing impairments.
Area of Science:
- Pediatric Oncology
- Audiology
- Ototoxicity
Background:
- Cisplatin is a common chemotherapy agent used in pediatric cancer treatment.
- Ototoxicity, including hearing loss, is a known side effect of cisplatin therapy.
- Understanding the incidence and characteristics of cisplatin-induced hearing loss in children is critical for long-term patient care.
Purpose of the Study:
- To investigate and describe hearing changes in children undergoing cisplatin therapy.
- To determine the prevalence of hearing loss associated with cisplatin treatment in a pediatric cohort.
Main Methods:
- Utilized a comprehensive audiological assessment battery.
- Included conventional, play, and visual reinforcement audiometry.
- Employed immittance audiometry, otoacoustic emissions (OAEs), and auditory brainstem response (ABR) for threshold determination.
Main Results:
- Identified sensorineural hearing loss in 26% (9 of 28) of the children studied.
- Hearing loss was bilateral and symmetrical, predominantly affecting high frequencies.
- The onset of hearing loss varied, occurring between 1 and 50 months post-chemotherapy and was not dose-dependent.
Conclusions:
- Cisplatin-induced hearing loss in children can occur independently of individual or cumulative dosage.
- Routine audiological evaluations are recommended post-chemotherapy due to unpredictable onset.
- Interventions such as hearing aids or assistive listening devices, and speech-language pathology, may be necessary.
Objective:
To describe hearing changes in a group of 28 children (age range, 8-180 mo) undergoing protocol-based cisplatin therapy.
Methods:
Conventional, play audiometry, visual reinforcement audiometry (VRA), immittance audiometry, transient click evoked otoacoustic emissions (OAEs), and auditory brainstem response (ABR) evoked potentials were used to assess peripheral sensitivity and for threshold determination.
Results:
Bilateral symmetrical high-frequency sensorineural hearing loss was noted in 9 of the 28 children (26%). Hearing loss was evident as early as 1 month after chemotherapy and as late as 50 months and was not dependent on individual or cumulative dosage of cisplatin.
Conclusions:
1) Presence of sensorineural hearing loss was independent of individual and/or cumulative dosage of cisplatin; 2) audiologic assessment should be incorporated into a child's periodic medical evaluations after chemotherapy treatment, as onset of sensorineural hearing loss cannot be predicted; 3) personal hearing aids may be indicated for those children with hearing loss affecting the low- to mid-frequencies; a personal assistive listening device (frequency modulated system) may be more appropriate for losses above 3000 Hz; and 4) evaluation and intervention by a speech-language pathologist may be indicated to address possible articulation or language development problems consequent to hearing loss.
