The Effect of Intratympanic Dexamethasone on Hearing Function in Cisplatin Chemotherapy, (Meta-Analysis)

Abstract

Background: Hearing loss due to cisplatin is still a major health problem. Cisplatin is an antineoplastic agent that is the first line treatment for various malignancies and can cause ototoxicity in the form of bilateral hearing loss. Dexamethasone has the potential to reduce the ototoxic effects of cisplatin. Intratympanic dexamethasone injection allows higher concentrations in the cochlea, and avoids systemic side effects.  Methods: This study was a meta-analysis of randomized control trial articles with hearing threshold and intratympanic dexamethasone injection vs no treatment as variables. The population are subjects with malignancies receiving cisplatin chemotherapy. The mean difference and standard deviation (Δ Mean + SD) of hearing thresholds in the intervention and control groups was assessed. The hearing frequencies examined were at 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, and 8000 Hz. Results: The database search yielded four eligible articles. There was no significant difference between intratympanic dexamethasone and no treatment at 500 Hz (p = 0.93; MD 0.13; CI95% -2.65 to 2.91), at 1000 Hz (p = 0.19; MD 2.09; CI95% -1.02 to 5.20), at 2000 Hz (p = 0.56; MD 0.21; CI95% -0.49 to 0.90), at 4000 Hz (p = 0.36; MD -0.46; CI95% -1.45 to 0.53), and at 8000 Hz (p = 0.13; MD -4.97; CI95% -21.75 to 1.46). Conclusion: There is no effect of intratympanic dexamethasone on hearing function in malignant patients with cisplatin chemotherapy. However, further RCT research using high frequency audiometry are needed to confirm this finding.