The utility of acoustic reflex thresholds and other conventional audiologic tests for monitoring cisplatin ototoxicity in the pediatric population.
OBJECTIVE
The sensitivity of acoustic reflex threshold changes for monitoring cisplatin ototoxicity in children was compared with the sensitivity of conventional audiometric tests.


METHODS
Acoustic reflex thresholds, thresholds for audiometric frequencies 0.250 Hz to 2 kHz and 3 kHz to 8 kHz, extended high-frequency (EHF) audiometry for 10 kHz to 16 kHz, and the articulation index (AI) were compared at six different cumulative dosage levels of cisplatin in 21 children, 3.08 yr to 19.25 yr of age.


RESULTS
Of these 21 patients, 100% showed significant changes in at least one portion of the test battery when cumulative dosages exceeded 401 mg/m2. EHF testing was found to be the most sensitive to ototoxicity once cumulative dosage levels of 150 to 250 mg/m2 were reached. Audiometric thresholds from 3 to 8 kHz, and acoustic reflex threshold changes were found to be the next most sensitive to ototoxicity at cumulative dosages of 251 to 400 mg/m2. No significant threshold changes were noted for frequencies from 250 Hz to 2 kHz.


CONCLUSIONS
Acoustic reflex threshold measures may prove to be a valuable addition to current ototoxic test protocols. Although it is currently not the most sensitive test to ototoxicity, it is one of the more objective tests. Further data must be collected to determine the clinical utility of acoustic reflex threshold testing to monitor ototoxicity.
Park
K R
KR
Washington University, St. Louis Children's Hospital, Missouri, USA.
D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects* / Q000494:pharmacology* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy; D012022:Reflex, Acoustic / Q000187:drug effects*
D002945:Cisplatin