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Updated: Aug 10, 2026
Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
cis-platinum ototoxicity in children
R A Weatherly1, J J Owens, F I Catlin
1Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, TX 77030.
Insights
Cis-platinum chemotherapy can cause hearing loss in children. Younger patients and those with prior radiation exposure are more susceptible. Regular audiologic evaluations are crucial for monitoring treatment effects.
Area of Science:
- Pediatric Oncology
- Audiology
- Ototoxic Drug Monitoring
Background:
- Cis-platinum is a widely used chemotherapy agent with known ototoxicity.
- A standardized audiologic evaluation protocol for pediatric patients receiving cis-platinum is lacking.
- Ototoxicity can lead to significant hearing impairment, impacting quality of life.
Purpose of the Study:
- To review audiologic evaluations in pediatric patients undergoing cis-platinum therapy.
- To identify factors influencing cis-platinum-induced hearing loss.
- To propose guidelines for audiologic monitoring in this population.
Main Methods:
- Retrospective review of audiograms from 48 pediatric patients.
- Analysis of auditory brain-stem response (ABR) and pure-tone audiometry results.
- Correlation of hearing changes with patient age, cis-platinum dosage, and cranial radiation exposure.
Main Results:
- Younger patients showed increased susceptibility to hearing changes.
- Hearing loss proportion and severity increased with successive cis-platinum doses.
- Prior cranial radiation exposure was strongly associated with hearing loss.
Conclusions:
- Age, cumulative cis-platinum dose, and cranial radiation are critical factors in ototoxicity.
- Pure-tone audiometry is a key component in monitoring hearing function.
- Guidelines for clinical audiometry are proposed for screening pediatric oncology patients.
Abstract:
Despite the recognized ototoxicity of cis-platinum, a clinical outline for the audiologic evaluation of patients receiving this drug has not been clearly defined. In a practical approach to this problem, the audiograms of 48 pediatric patients referred for monitoring during planned cis-platinum therapy were reviewed. Eleven patients tested with auditory brain-stem response (ABR) audiometry demonstrated several limitations of this modality. Fourteen children underwent initial ABR testing followed by at least two pure-tone audiograms. The remaining 23 patients had their hearing evaluated by pure-tone audiometry only. Various factors such as patient age, cis-platinum dosage, and cranial radiation exposure were analyzed for apparent effect. Younger patients tended to be more susceptible to audiologic changes with the administration of cis-platinum. The proportion of patients who demonstrated a hearing loss increased with successive dosing as did the severity of the hearing loss. Prior exposure to cranial radiation was strongly linked to the development of hearing loss following cis-platinum therapy. Guidelines are presented regarding the use of clinical audiometry in the screening of these pediatric oncology patients.
