Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2025
Quantitative Assessment of Vestibular Function by Video Head Impulse Test and Vestibular-Evoked Myogenic Potential During Cisplatin-Based Chemoradiation.
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Takada Natsuki, Okuda Hiroshi, Shibata Hirofumi, Obara Natsuko, Mori Kenichi, Terazawa Kosuke, Kawaura Ryo, Iinuma Ryota, Kato Rina, Yamada Tatsuhiko, Tsunoki Takuro, Makita Chiyoko, Mori Takayuki, Ogawa Takenori
Аннотация
INTRODUCTION: This study aimed to determine the effects of cisplatin on vestibular function.
STUDY DESIGN: Prospective cohort study.
METHODS: We measured vestibulo-ocular reflex gain (VOR gain), cervical vestibular-evoked myogenic potential amplitude (cVEMP amplitude) and hearing acuity before and after treatment in 28 patients treated with cisplatin-based chemoradiation to determine changes in hearing and vestibular function.
RESULTS: VOR gain did not decrease significantly before and after treatment, but cVEMP amplitude decreased significantly (p < 0.01). Air and bone hearing level worsened significantly (p < 0.01). The VOR gain in the group receiving more than 200 mg/m2 of cisplatin was significantly decreased compared with the group receiving less than 200 mg/m2 (p < 0.05). The cVEMP amplitude and hearing level were not significantly different between the two groups. Even after adjusting for age and inner ear radiation dose, VOR gain was inversely related to increasing cisplatin dose (β = 0.19; SE = 0.08).
CONCLUSIONS: Patients treated with cisplatin-based chemoradiotherapy exhibited decreased VOR gain. Patients should undergo vestibular and auditory testing before and after chemoradiation to detect potential vestibular impairment earlier, and prompt initiation of vestibular physical therapy would increase patients' quality of life.
STUDY DESIGN: Prospective cohort study.
METHODS: We measured vestibulo-ocular reflex gain (VOR gain), cervical vestibular-evoked myogenic potential amplitude (cVEMP amplitude) and hearing acuity before and after treatment in 28 patients treated with cisplatin-based chemoradiation to determine changes in hearing and vestibular function.
RESULTS: VOR gain did not decrease significantly before and after treatment, but cVEMP amplitude decreased significantly (p < 0.01). Air and bone hearing level worsened significantly (p < 0.01). The VOR gain in the group receiving more than 200 mg/m2 of cisplatin was significantly decreased compared with the group receiving less than 200 mg/m2 (p < 0.05). The cVEMP amplitude and hearing level were not significantly different between the two groups. Even after adjusting for age and inner ear radiation dose, VOR gain was inversely related to increasing cisplatin dose (β = 0.19; SE = 0.08).
CONCLUSIONS: Patients treated with cisplatin-based chemoradiotherapy exhibited decreased VOR gain. Patients should undergo vestibular and auditory testing before and after chemoradiation to detect potential vestibular impairment earlier, and prompt initiation of vestibular physical therapy would increase patients' quality of life.