Beck A, Maurer J, Welkoborsky H J, Mann W
Universitäts-HNO-Klinik Mainz.
HNO. 1992 Apr;40(4):123-7.
The aim of this study was to detect changes of transient evoked otoacoustic emissions (TEOAE) during chemotherapy with cisplatin and fluorouracil (5FU). A review of the literature reveals that the incidence of cisplatin ototoxicity varies from 9% to 50%; this variation is due to differences in doses, duration of administration, to the criteria for ototoxicity and on audiological methods. Three cycles of chemotherapy (1000 mg/m2 5FU from day 1 to 5 and 100 mg/m2 cisplatin on day 1) were given to 12 patients; the OAE were measured before chemotherapy and after each administration. In 86% of the ears measured we found changes in the TEOAE; the mean values for the amplitude of the TEOAE decreased about 13% after the end of the chemotherapy. Pure tone thresholds were reduced in almost 50% of the measured ears. The decrease of amplitude of TEOAE is an early sign of an ototoxic secondary effect, probably due to damage to the outer hair cells. TEOAE is a sensitive method for detecting ototoxicity in cisplatin-treated patients and more reliable than pure-tone audiometry or evoked acoustic potentials.
本研究的目的是检测顺铂和氟尿嘧啶(5FU)化疗期间瞬态诱发耳声发射(TEOAE)的变化。文献综述显示,顺铂耳毒性的发生率在9%至50%之间;这种差异是由于剂量、给药持续时间、耳毒性标准以及听力检测方法的不同所致。对12例患者进行了三个周期的化疗(第1至5天给予1000mg/m²的5FU,第1天给予100mg/m²的顺铂);在化疗前及每次给药后测量耳声发射。在86%的测量耳中,我们发现TEOAE有变化;化疗结束后,TEOAE的平均幅值下降了约13%。几乎50%的测量耳纯音听阈降低。TEOAE幅值降低是耳毒性继发效应的早期迹象,可能是由于外毛细胞受损所致。TEOAE是检测顺铂治疗患者耳毒性的一种敏感方法,比纯音听力测定或诱发听性电位更可靠。