Quantitative Assessment of Vestibular Function by Video Head Impulse Test and Vestibular-Evoked Myogenic Potential During Cisplatin-Based Chemoradiation.

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.