[Vestibulopathies and adult cancers: A literature review]

Therapeutics used in cancer treatment can cause vestibular ototoxicity, which is particularly challenging to detect due to the frequent occurrence of nausea and vomiting in patients experiencing significant fatigue and stress. An appropriate diagnosis enables optimal symptom correction, reduces the risk of falls, and improves quality of life.

Following a concise overview of the anatomy, physiology, and principles of vestibular exploration, a narrative review of the primary vestibulopathies encountered in cancer patients is conducted. This review details their exploration and the anti-cancer treatments responsible for vestibular ototoxicity.

Vestibular ototoxicity from systemic treatments typically presents as chronic bilateral vestibulopathy. Vestibular functional tests differentiate between central and peripheral lesions, quantify the damage, and guide imaging assessments. Platinum salts are the main agents causing cochlear ototoxicity, although their toxicity mechanisms on the vestibular system remain unclear. Cases of vestibular ototoxicity have been described with immune checkpoint inhibitors. Radiotherapy and direct tumor invasion can also cause vestibular damage. All vestibular alterations increase the risk of falls, particularly in the elderly. A vestibular assessment by an otolaryngologist is indicated; treatment usually involves vestibular rehabilitation.

Collaboration between oncologists and otolaryngologists is crucial for evaluating vestibular function during cancer treatments with potential ototoxicity.