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Hearing impairment: 6 case reports Six patients, three males and three females, developed hearing impairment after chemotherapy with cisplatin (5 patients), or cisplatin and carboplatin (1) [routes and times to reactions onset not stated; not all outcomes stated]. The patients were diagnosed with cancer at the age of 2.6–14.3 years, and received cisplatin 320-500 mg/m2 as part of their chemotherapy regimen; patient 1 also received carboplatin 3000 mg/m2. On audiological evaluation 12.3–21.5 years after chemotherapy completion, aged 17.7–33.9 years, all patients exhibited hearing loss due to ototoxicity. Patients 1, 5 and 6 also developed occasional tinnitus, and patient 3 developed constant tinnitus which prevented him from falling asleep. All patients were classified as hearing-impaired, with scores of 1, 2 or 3 according to Brock’s grade scoring limit of hearing loss. Pure-tone average-mid (0.5, 1, 2kHz) and -high (3, 4, 6kHz) decibel hearing levels in the better ear were 1.7–30.0 and 41.7–88.3, respectively. Corresponding values in the worse ear were 1.7–41.7 and 43.3–100.0, respectively. The average word recognition score in a quiet environment was 91.7% for the better ear and 89.3% for the worse ear. In noise, the average word recognition score was 32.8% for the better ear and 24.7% for the worse ear. Patients 1, 2, 3 and 4 underwent bilateral fitting of customised open-fitting hearing aids. They subsequently experienced improvements in word recognition at all or most signal to noise ratios, as well as improvements in their ability to hear speech, and fewer difficulties with speech distortion. Patient 3 reported that his tinnitus was less aggressive and disturbing when he used the hearing aid. Author comment: "[C]isplatin-induced ototoxicity may not only cause peripheral hearing deficits, but might be a cause of some central deficits which influence word recognition in noise." Einarsson EJ, et al. Severe difficulties with word recognition in noise after platinum chemotherapy in childhood, and improvements with open-fitting hearingaids. International Journal of Audiology 50: 642-51, No. 10, Oct 2011 803068441 Sweden

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Reactions 24 Mar 2012 No. 1394