Inner ear histopathology in patients treated with cis-platinum.

Temporal bone histopathology was studied in five patients (aged 51-67) who received cis-diamminedichloroplatinum (DDP) chemotherapy for head and neck squamous cell carcinoma. In each case, sensorineural hearing loss occurred during the course of treatment and temporal bones were acquired 3-5 hours postmortem for anatomical study. Scanning electron microscopy revealed acute degenerative changes in cochlear hair cells that appeared to be the result of drug treatment. However, the presence of age-related degeneration made it difficult to unequivocally identify hair cell loss due solely to ototoxicity. In one patient, a decrement in vestibular function was observed during DDP treatment. Postmortem examination showed severe degeneration of the maculae and cristae which could be correlated with the absence of caloric response seen after chemotherapy.