Hearing impairment

Abstract

Berg et al. summarize 11 studies that describe factors reported to be associated with cisplatin toxicity in pediatric patients.12 These factors include bolus administration of drug,13 prior cranial irradiation14,15 and central nervous system neoplasia.16 Although certain studies show a relationship between young age at time of treatment and cisplatin ototoxicity,14,16 other reports do not confirm this association.17 Similarly, most studies, but not all, associate cumulative cisplatin dose with ototoxicity.12,14-16 According to Schell et al., cisplatin-related hearing loss appears to have a triphasic pattern.16 Hearing remains normal until a certain amount of drug has been delivered. After this point, damage to OHCs in the basal turn progresses until maximal effect is reached. This damage usually affects hearing at approximately 75 dB.19 Once the maximal threshold for stimulation of OHCs occurs, inner hair cells (IHCs) are then stimulated. However, because these structures are relatively resistant to the effects of cisplatin, a plateau occurs in the progression of damage (Figure 2d.1).