June 1993

High-Frequency Monitoring for Early Detection of Cisplatin Ototoxicity

Author Affiliations

From the Department of Veterans Affairs (Dr Fausti), the Auditory Research Laboratory (Messrs Henry and Frey and Mss Schaffer and Olson), and the Hematology/Oncology Service (Dr Bagby), Portland (Ore) Veterans Affairs Medical Center; and the Department of Otolaryngology (Dr Fausti) and the Division of Hematology and Medical Oncology Service (Dr Bagby), Oregon Health Sciences University, Portland.

Arch Otolaryngol Head Neck Surg. 1993;119(6):661-666. doi:10.1001/archotol.1993.01880180081015

• Cisplatin can cause irreversible hearing loss initially detectable as impairment of high-frequency hearing with progression to lower frequencies. Many patients receiving cisplatin are too ill to tolerate lengthy audiometric testing. Therefore, a rapid and sensitive high-frequency monitoring strategy to detect cisplatin-induced ototoxicity is needed. Serial conventional (0.25 to 8 kHz) and high-frequency (≥8 kHz) threshold monitoring was performed in patients receiving cisplatin, resulting in 84% of ears showing hearing loss, of which 71% were detected first in frequencies of 8 kHz or greater. By analysis according to an individualized, specific high-frequency range, early identification of hearing loss occurred in 94% of ears showing change. This five-frequency procedure is a sensitive detector of ototoxicity and is proposed as an alternative monitoring protocol for patients receiving cisplatin who cannot tolerate extended testing.

(Arch Otolaryngol Head Neck Surg. 1993;119:661-666)