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Updated: Aug 6, 2026
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Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
Cisplatin-Induced Hearing Loss Prevention With Intratympanic Therapy Systematic Review and Meta-Analysis
Zachary A Kons1,2, Calvin J Kersbergen1,2, Deborah Goss1,2
1Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear.
Summary
Intratympanic injections of dexamethasone, N-acetylcysteine, or sodium thiosulfate did not consistently prevent cisplatin-induced hearing loss. Limited evidence suggests sodium thiosulfate may reduce ototoxicity, warranting further investigation.
Area of Science:
- Otolaryngology
- Pharmacology
- Oncology
Background:
- Cisplatin-induced hearing loss (CIHL) is a common, long-term side effect of cisplatin chemotherapy.
- Intratympanic (IT) injections are being explored as a method to prevent CIHL.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of agents administered via IT injection for preventing CIHL.
- To identify which agents have been studied for CIHL prevention using the IT route.
Main Methods:
- A systematic review and meta-analysis of prospective randomized trials were conducted.
- Searches were performed across OVID Medline, Embase, Web of Science, and Cochrane Library.
- Data on demographics, audiometry, and treatment were collected and analyzed using random-effects models.
Main Results:
- Ten studies involving 284 patients investigated IT dexamethasone, N-acetylcysteine (NAC), and sodium thiosulfate (STS).
- Pooled analysis showed no significant difference in hearing thresholds between treatment and control ears for IT agents overall, dexamethasone, or NAC.
- While pooled analysis for STS was not feasible, one study indicated STS significantly reduced ototoxicity (40% vs. 85%).
Conclusions:
- Currently, no intratympanic agent has demonstrated consistent efficacy in preventing cisplatin-induced hearing loss.
- Emerging data suggest IT sodium thiosulfate may have a role in reducing ototoxicity.
- Further clinical trials are required to confirm the effectiveness of IT agents for CIHL prevention.
