Monitoring of cisplatin ototoxicity by distortion-product otoacoustic emissions.

Cisplatin is one of the most commonly used chemotherapeutic agents. However, ototoxicity, in particular, damage to the outer hair cells of the cochlea, is one of its major side effects. Otoacoustic emissions are acoustical signals that originate from the contractile activity of the outer hair cells. They are transmitted from the cochlea to the external ear canal via the middle ear apparatus. Testing is quick, painless, objective, and non-invasive. Distortion-product otoacoustic emissions (DPOAEs) are one of the evoked types of otoacoustic emissions. They are quite sensitive to any insult to the outer hair cells, even before damage is manifested in pure tone audiometry (PTA). A patient, who was on cisplatin chemotherapy due to prostate cancer, was monitored periodically for ototoxicity using DPOAEs and PTA. DPOAEs were found to detect ototoxicity one course of chemotherapy earlier than PTA during cisplatin chemotherapy. The clinical application and sensitivity of DPOAEs in monitoring ototoxicity were discussed.