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Transient-evoked otoacoustic emissions in children after cisplatin chemotherapy
1Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, USA.
Insights
Cisplatin chemotherapy can cause hearing loss in children. Transient-evoked otoacoustic emissions (TEOAEs) correlate with hearing damage, especially in higher frequencies, and are linked to younger age and higher cisplatin doses.
Area of Science:
- Pediatric Otolaryngology
- Ototoxicology
- Audiology
Background:
- Cisplatin is a common chemotherapy agent used in pediatric oncology.
- Cisplatin-induced ototoxicity is a significant concern, but data in children is limited.
- Otoacoustic emissions offer a non-invasive method for hearing assessment.
Purpose of the Study:
- To investigate the correlation between transient-evoked otoacoustic emissions (TEOAEs) and audiographic findings in pediatric patients previously treated with cisplatin.
- To identify risk factors associated with cisplatin-induced hearing loss in children.
Main Methods:
- A cohort of 12 pediatric patients with prior cisplatin exposure was studied.
- Transient-evoked otoacoustic emissions (TEOAEs) were measured and compared with pure-tone audiometry results.
- Statistical analysis was performed to assess correlations and identify risk factors.
Main Results:
- Significant sensorineural hearing loss was observed at higher frequencies (4-8 kHz) in most patients.
- TEOAEs were measurable in 11 out of 12 patients.
- A significant correlation was found between TEOAE reproducibility and pure-tone thresholds when middle ear function was normal (r = -0.69, p = 0.008).
- Younger age at first cisplatin dose, higher number of chemotherapy cycles, and higher cumulative cisplatin dose were associated with increased hearing loss.
Conclusions:
- Transient-evoked otoacoustic emissions (TEOAEs) are a valuable tool for monitoring cisplatin ototoxicity in pediatric patients.
- Hearing loss is prevalent at higher frequencies, and TEOAEs can detect these changes.
- Younger age and higher cumulative cisplatin exposure are risk factors for hearing impairment.
Abstract:
Little is known about cisplatin ototoxicity in pediatric patients. Measurement of otoacoustic emissions is a rapid, reproducible, objective method of evaluating hearing. We examined whether transient-evoked otoacoustic emissions in pediatric patients exposed to cisplatin in the past correlated with audiographic findings. Twelve patients were entered into the study (mean age at treatment 7.8 years, mean cumulative dose 442.5 mg/mm2, mean 7.1 doses). Hearing at 3000 Hz was preserved in 82.6% of patients. In the higher frequencies significant sensorineural hearing loss was noted: 43.5% at 4 kHz; 81.0% at 6 kHz; and 90.5% at 8 kHz. Transient-evoked otoacoustic emissions were measurable in 11 of 12 patients. Middle ear disease accounted for abnormal otoacoustic emission seen in three patients (1 with effusion, 2 with significant negative middle ear pressure). When the middle ear was normal, a statistically significant correlation was seen between the transient-evoked otoacoustic emissions reproducibility and pure-tone threshold (correlation coefficient = -0.69, p = 0.008). Increased hearing loss was also associated with young age at first dose of cisplatin (p = 0.044), high number of chemotherapy cycles (p = 0.042), and high cumulative dose (p = 0.042).
