Left-right asymmetry in hearing loss following cisplatin therapy in children--the left ear is slightly but significantly more affected.
OBJECTIVE
Bilateral symmetric high frequency hearing loss is regarded as one of the main characteristics of cisplatin-induced ototoxicity. Hair-cell damage because of cisplatin is discussed as the leading cause of hearing loss. Our observations in long-term audiological follow-up of children treated with cisplatin did not always show the anticipated symmetry of hearing loss.


METHODS
Pure-tone audiograms of 55 (34 m, 21 f) children receiving chemotherapy with cisplatin at Muenster university hospital were analyzed. We compared pure tone hearing thresholds, transient evoked otoacoustic emissions levels and distortion product otoacoustic emissions levels before and after chemotherapy with cisplatin.


RESULTS
After therapy, the 55 children showed slightly higher average hearing levels in the range 2000 to 8000 Hz in the left ear. The side difference was significant at 4000, 6000, and 8000 Hz. In girls, the effect was less pronounced than in boys.


CONCLUSIONS
This result, on the one hand, indicates that the auditory system is already responding asymetrically at the cochlear level, on the other hand it underscores the need for further research into the pathophysiology of platinum ototoxicity. There are parallels with stronger effects to the left ear in oiseinduced hearing loss as described in literature. Special attention should be given to possible supracochlear pathways of damage. Clinicians should consider that cisplatin associated hearing loss is not necessarily symmetric.
Schmidt
Claus-Michael
CM
Department of Phoniatrics and Pediatric Audiology, Muenster University Hospital, Muenster, Germany. michael.schmidt@uni-muenster.de
Knief
Arne
A
Lagosch
Agatha Katharina
AK
Deuster
Dirk
D
am Zehnhoff-Dinnesen
Antoinette
A
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000187:drug effects; D001859:Bone Neoplasms / Q000188:drug therapy; D001932:Brain Neoplasms / Q000188:drug therapy; D002528:Cerebellar Neoplasms / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D007839:Functional Laterality; D006312:Hearing Loss, Bilateral / Q000139:chemically induced* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy; D009447:Neuroblastoma / Q000188:drug therapy; D012516:Osteosarcoma / Q000188:drug therapy; D017084:Otoacoustic Emissions, Spontaneous / Q000187:drug effects; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D002945:Cisplatin