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Objective: To prospectively examine early hearing damage detectable with distortion product otoacoustic emission (DPOAE) after the first cycle of cisplatin treatment of patients with testicular tumor.Study Design: Both ears of 137 consecutive patients were examined at 0.75 to 8 kHz before (B) and after (A) the first cycle of cisplatin (dose: 100 mg/m2 / 5 days).Methods: The mean amplitudes (B vs. A) were compared with paired t test at each frequency. Ototoxic changes were considered when an individual amplitude difference (B-A) > 14 dB at 0.75 Hz or > 7 db at 1 to 8 kHz occurred.Results: The mean amplitudes were statistically significantly lower after first cycle at 0.75, 6, and 8 kHz. The majority of patients (96%) presented positive differences (B-A) in one or both ears; in 85 (62%) cases, the positive difference reached the level of ototoxicity out of which 34 (40%) and 19 (22%) of patients suffered ototoxicity in one or both ears, respectively. The difference between right and left ears in distribution of ototoxic cases was nonsignificant. Forty-five (33%) and four (3%) patients showed ototoxicity at two or more frequencies in one or both ears, respectively. An increased proportion of ototoxic cases can be seen at 0.75 to 1 kHz and 6 to 8 kHz.Conclusion: After the first cycle of cisplatin treatment, early ototoxicity occurs in close to two-thirds of patients, as identified by measuring DPOAE. Therefore, further research for biomarkers is required, which can predict patients at risk in order to avoid an irreversible hearing loss by personalized, preventive therapies.Level Of Evidence: 4. Laryngoscope, 127:1909-1915, 2017. [ABSTRACT FROM AUTHOR]

Introduction: Hearing loss is a sensory impairment that impairs speech understanding, communication and therefore the quality of life. Sometimes the patient's perceived loss of function is exaggerated; subjective and objective test results are inconsistent, the subjectively reported hearing loss is more significant, and in these cases functional hearing loss is considered., Objective: Our aim was to collect and retrospectively analyze cases with the diagnosis of functional hearing loss, in order to draw conclusions about the characteristics of functional hearing loss, the signs and conditions that may be of attention and the consideration of appropriate rehabilitation., Methods: Subjective tests were performed with pure-tone auditory threshold, speech understanding and communication tests, which were compared with the results obtained with objective impedance measurements, stapedial reflex tests, otoacoustic emission measurements, and brainstem evoked response recordings. Imaging studies, psychologist, psychiatrist, neurologist, neurologist and other co-specialists were involved as needed. We excluded cases of deception deliberately intended to obtain financial or other benefits., Results: Between 2007 and 2022, 19 patients were diagnosed with functional hearing loss. The majority (17 cases) were female, the complaints were prevalent at a young age (10-41 years); the average age in the study population was 19.6 years, and the majority of patients (13 cases) were children aged 10-17 years. No organic cause was found in 11 cases, and in the remaining cases no detectable organic abnormality explained the extent of the hearing loss experienced by the patient. The degree of functional hearing loss varied (35-120 dB), with an average of 60,2 dB., Conclusion: Recognizing and diagnosing functional hearing loss is very difficult and requires a complex series of tests and professional cooperation. Without recognition, the patient may receive unjustified, even harmful and financially burdensome care, which may lead to the deterioration of his condition. Orv Hetil. 2023; 164(8): 283-292.

Cisplatin-based chemotherapy results in high cure rate in testicular cancer. The issue of toxicity is of special concern in young men with a probability of cure of at least 70-80% even in disseminated disease. As the literature shows, the ototoxic side effects of cisplatin have been studied mostly by conventional method. The authors used distortion product otoacoustic emission to detect the long-term ototoxic effect of cisplatin in 223 patients with a median follow-up time of 4.27 years (range 0.5-20 years) and a median age of 37 years (range 18-55 years). Cisplatin (20 mg/m(2) body surface) was administered for five days per cycle, in combination with other antitumor drugs. The control group consisted of 40 testicular cancer patients who did not receive chemotherapy, with a median age of 35 years (range 16-54 years). A detailed medical history based on a standardized questionnaire evaluated hearing complaints and audiological risk factors, such as head injuries, chronic otitis media, previous noise exposure and familial hearing loss. DPOAE was measured at 8 frequencies from 750 to 8000 Hz. No amplitude changes were detected in patients receiving =300 mg/m(2) cisplatin. At higher doses, contrary to the literature, not only high frequencies were affected: our method could detect significant hearing impairment at lower frequencies important for speech perception in patients receiving at least 400 mg/m(2) cisplatin. The lower frequencies where significant amplitude changes were detected were 3000 Hz at 400 mg/m(2), and 1500, 2000 and 3000 Hz at 500-600 mg/m(2). We detected the worst hearing in the case of patients who had symptomatic ototoxicity. Age and the cumulative dose of cisplatin proved statistically significant risk factors, while smoking or noise exposure did not have predictive value. As a conclusion, DPOAE is a fast, noninvasive and reliable method for the detection of late ototoxicity in testicular cancer patients. In our study hearing loss correlated with the cumulative dose of cisplatin. Hearing impairment contributes to the already compromised situation of cancer patients.