Cisplatin ototoxicity in children: a practical grading system

Med Pediatr Oncol. 1991;19(4):295-300. doi: 10.1002/mpo.2950190415.


A long-term follow-up study was carried out to assess ototoxicity in children who had been treated for a malignant tumour with "standard dose" cisplatin (60-100 mg/m2 per course), and were at least 2 years from stopping treatment. The median age at diagnosis was 2 years 2 months (range 1 month to 13.5 years). On the basis of hearing assessment by pure-tone audiometry, a practical grading system of hearing loss from 0 to 4 is proposed. Moderate to severe high-frequency hearing loss (grade 2-4) was found in half the children and 10 require appropriate hearing aids. The risk of developing ototoxicity increased significantly with the cumulative cisplatin dose (P = 0.027), although there was considerable individual susceptibility. Serial follow-up testing, to a median of 4 years after completion of cisplatin treatment, showed no recovery of hearing in any of these children. We suggest careful monitoring of young children by a consultant audiological physician throughout treatment with cisplatin, particularly when doses of 400 mg/m2 and over have been reached. Alternative chemotherapy should be discussed if grade 2 ototoxicity develops.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Audiometry, Pure-Tone
  • Child
  • Child, Preschool
  • Cisplatin / adverse effects*
  • Follow-Up Studies
  • Glomerular Filtration Rate / drug effects
  • Hearing Loss, High-Frequency / chemically induced*
  • Hearing Loss, High-Frequency / classification
  • Humans
  • Infant
  • Monitoring, Physiologic


  • Cisplatin