Impact of Cisplatin on Hearing: Analysis Using PTA, High-Frequency Audiometry, DPOAE, and Speech-in-Noise Test

Objective. To assess hearing loss in patients with cancer receiving cisplatin-based chemotherapy using high-frequency pure tone average (HFPTA), distortion product otoacoustic emissions (DPOAEs), and the speech-in-noise (SPIN) test, and to identify associated factors. Study Design. Prospective study. Setting. Tertiary care hospital. Methods. Patients scheduled for cisplatin chemotherapy were included in the study. Audiological assessments, including HFPTA, DPOAE, and SPIN tests, were conducted at baseline, after two cycles, and after four cycles of chemotherapy. Clinical data were also analyzed. Results. One-third of the population was aged between 51 and 60 years. Higher cumulative doses of cisplatin were administered for bladder and head and neck cancers, reaching up to 3200 mg over four cycles. Most patients had normal hearing at baseline, but HFPTA detected significant hearing loss at various frequencies (8-20 kHz) over follow-ups. DPOAE showed increased negative emissions over time. A weak, negative correlation between cisplatin dose and extended high-frequency audiometry (maximum -0.311 at 18 kHz) and DPOAE (maximum -0.173 at 1500 Hz) was observed. The SPIN test suggested reduced SPIN performance with treatment progression. However, correlation with cisplatin doses was not statistically significant. Conclusion. The study underscores the importance of integrated audiological monitoring in detecting early ototoxicity in cisplatin-treated patients, emphasizing the need for periodic auditory assessments during chemotherapy. SPIN test is a simple tool offering significant potential for ototoxicity monitoring.