Intratympanic Dexamethasone Role in Hearing Protection in Cancer Patients

Area of Science:

• Ototoxicity research
• Cancer treatment side effects
• Audiology

Background:

• Chemoradiotherapy for head and neck cancer can cause hearing loss.
• Cisplatin, a common chemotherapeutic agent, is known for its ototoxic effects.
• Intratympanic dexamethasone (ITD) is being investigated as a protective measure.

Purpose of the Study:

• To evaluate the effectiveness of intratympanic dexamethasone (ITD) in preserving hearing.
• To assess the impact of ITD on the hearing profiles of head and neck cancer patients undergoing chemoradiotherapy.

Main Methods:

• Prospective case-control study involving 100 head and neck cancer patients.
• Patients received cisplatin concurrent with radiotherapy.
• ITD was administered to one ear (experimental) before each cisplatin session, with the other ear serving as control.
• Pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE) were used for hearing assessment at baseline and follow-up (6 and 12 weeks).

Main Results:

• Significant hearing threshold changes were observed at higher frequencies (≥ 6 kHz) in the control ear by 12 weeks.
• The experimental ear showed less hearing loss at high frequencies compared to the control ear.
• Distortion product otoacoustic emissions indicated greater high-frequency loss in the control group than the experimental group at 12 weeks.

Conclusions:

• Intratympanic dexamethasone (ITD) shows potential in mitigating cisplatin-induced hearing loss.
• ITD's effectiveness is limited at higher frequencies, as the basal turn of the cochlea is more vulnerable to cisplatin ototoxicity.
• Further research is warranted to optimize ITD application for comprehensive hearing protection.