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Clinical trials evaluating transtympanic otoprotectants for cisplatin-induced ototoxicity: what do we know so far?

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Background Cisplatin (CDDP) chemotherapy can cause serious side effects including irreversible and progressive hearing loss. Studies have aimed to assess potential protective strategies; however, systemic treatments have presented variable results,… Click to show full abstract

Background Cisplatin (CDDP) chemotherapy can cause serious side effects including irreversible and progressive hearing loss. Studies have aimed to assess potential protective strategies; however, systemic treatments have presented variable results, and potential interactions with CDDP have limited clinical trials. Methods A review of the literature was performed in order to evaluate clinical trials that have studied a transtympanic approach as an otoprotectant strategy. Results Six clinical trials were included. While a transtympanic approach can limit side effects and avoid interactions with CDDP, recurrent issues have been expressed including which otoprotectant to test, time delays between CDDP treatment and transtympanic injections, side effects such as pain and dizziness, concentrations, and number of injections. Clinical trials have used sodium thiosulfate, N -acetylcysteine and dexamethasone. Conclusions While a transtympanic approach seems like an attractive strategy, further research is needed to clarify which is the optimal otoprotectant, its dosage, and the number of injections.

Keywords: evaluating transtympanic; trials evaluating; transtympanic approach; cisplatin; clinical trials; side effects

Journal Title: European Archives of Oto-Rhino-Laryngology
Year Published: 2020

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