Early detection of cisplatin ototoxicity. Selected case reports.

A recently developed high frequency auditory measurement technique was applied to a sample of patients receiving the antineoplastic agent cis-dichlorodiammineplatinum II (cisplatin [CDDP, DDP]). Ototoxicity as a result of cisplatin administration is well documented. The ability to detect ototoxicity, however, varies with the methods and instrumentation utilized, and the criteria by which ototoxicity is defined. The auditory function of subjects receiving cisplatin for genitourinary tumors and head and neck cancers was serially monitored with conventional audiometry and with a high frequency testing system. Results reveal a high incidence of nonreversible cochlear toxicity with a predilection for involvement of the higher frequencies. Cochlear toxicity was detected earlier with the high frequency evaluation system than with conventional audiometry. The case reports presented are characteristic of the type and magnitude of auditory changes observed.