Temporal bone histopathology of cisplatin ototoxicity

Cisplatin (cis-diamminedichloroplatinum II) is a potent chemotherapeutic agent that is useful in the treatment of a variety of malignancies. Ototoxicity is a well-known adverse side effect of this drug and has been widely described in reports on clinical and animal studies. Few human temporal bone studies, however, have been performed for cisplatin ototoxicity. This report presents four cases of cisplatin ototoxicity in patients from whom temporal bone specimens with minimal post-mortem autolysis were obtained at autopsy. All patients received between 1 and 6 cycles of cisplatin with doses ranging from 100 to 165 mg/M2 per cycle. None of the patients received significant amounts of aminoglycosides or loop diuretics. Histopathologic changes included loss of inner and outer hair cells in the basal turn of the cochlea, degeneration of the stria vascularis, and a significant decrease in spiral ganglion cells predominantly in the upper turns.