Shetty Shama, Bhandary Satheesh Kumar, Bhat Vadisha, Aroor Rajeshwary, Shetty Jayarama, Dattatreya T
Department of ENT, KSHEMA, Mangalore, India.
Present Address: Department of ENT, Kasturba Medical College, Manipal, India.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):164-169. doi: 10.1007/s12070-020-01933-7. Epub 2020 Jul 1.
Cisplatin is a chemotherapeutic agent effective against head and neck carcinoma but unfortunately it is cochleotoxic. This study has been designed to investigate the efficacy of OAE in identifying early effects of cisplatin on the cochlea and the importance of protocol for audiological monitoring of cisplatin induced ototoxicity. This is a prospective observational study conducted from October 2012 to September 2014 on 70 patients, receiving Cisplatin for various malignant conditions. Audiological criteria for ototoxicity was considered as a difference of 10 d B or more in pure tone thresholds of two or more adjacent frequencies in conventional audiometry and in DPOAE-Signal noise ratio less than 6 dB or DPOAE amplitude less than 20 dBSPL (irrespective of SNR > 6 dB). According to PTA, 60.7% patients showed ototoxicity after completion of chemotherapy. In DPOAE, according to SNR and amplitude criteria more than 60% patients showed ototoxicity after first cycle of cisplatin at high frequencies (4-8 kHz). DPOAEs is a sensitive tool for early detection of ototoxicity and protocol is necessary for monitoring ototoxicity in patients receiving cisplatin to improve the quality of life.
顺铂是一种对头颈癌有效的化疗药物,但不幸的是它具有耳蜗毒性。本研究旨在调查耳声发射(OAE)在识别顺铂对耳蜗早期影响方面的有效性以及顺铂诱导耳毒性的听力学监测方案的重要性。这是一项前瞻性观察性研究,于2012年10月至2014年9月对70例因各种恶性疾病接受顺铂治疗的患者进行。耳毒性的听力学标准被认为是在传统听力测定中两个或更多相邻频率的纯音阈值相差10 dB或更多,以及畸变产物耳声发射(DPOAE)-信噪比小于6 dB或DPOAE幅度小于20 dBSPL(无论信噪比> 6 dB)。根据纯音平均听阈(PTA),60.7%的患者在化疗完成后出现耳毒性。在DPOAE方面,根据信噪比和幅度标准,超过60%的患者在顺铂第一周期后高频(4 - 8 kHz)出现耳毒性。DPOAE是早期检测耳毒性的敏感工具,对于接受顺铂治疗的患者监测耳毒性以提高生活质量而言,方案是必要的。