The Relationship Between Cisplatin-related and Age-related Hearing Loss During an Extended Follow-up

Laryngoscope. 2020 Sep;130(9):E515-E521. doi: 10.1002/lary.28543. Epub 2020 Feb 17.


Objectives: Cisplatin-related hearing loss (HL) is claimed to progress after treatment. This controlled longitudinal study with extended follow-up investigates HL in testicular cancer survivors (TCSs) after cisplatin-based chemotherapy (CBCT).

Study design: Controlled longitudinal study.

Methods: Eighty-two TCSs treated with CBCT between 1980 and 1994 in Norway participated in two surveys (S1/S3), including pure-tone audiograms (0.125-8 kHz) and self-reported HL, 12 and 31 years after treatment, respectively. Hearing thresholds were age-adjusted based on age-matched hearing thresholds from the general population (controls). Hearing loss was defined as thresholds >20 dB at any frequency.

Results: Between the two surveys, the prevalence of high-frequency HL (4, 6, and 8 kHz) increased from 73% to 94% but approached those of the aging general population after age adjustment. In TCSs aged >40 years at first survey, HL at the subsequent survey equaled that of controls. Self-reported HL increased from seven (9%) at S1 to 20 (26%) at S3. At S1, age-adjusted HL was identified in all (seven) TCSs reporting decreased hearing whereas at S3, hearing thresholds did not differ from controls in seven out of 20 patients reporting HL.

Conclusion: CBCT-related ototoxicity causes high-frequency HL, but in contrast to reports from follow-up studies from the first post-treatment decade, no major progression was found beyond the first post-treatment decade for frequencies 0.125-8 kHz. Importantly, with extended follow-up, hearing thresholds of patients approach those of the general population, possibly due to a less-than-additive effect with age-related hearing loss (ARHL) in CBCT-treated patients. Age-and sex-matching is strongly advised in long-term follow-up of CBCT-related ototoxicity. Specificity for detecting ototoxicity with self-reported questionnaires decreases with extended follow-up.

Level of evidence: 3 Laryngoscope, 130:E515-E523, 2020.

Keywords: Ototoxicity; aging; cisplatin; hearing-loss.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aging
  • Antineoplastic Agents / adverse effects*
  • Audiometry, Pure-Tone
  • Auditory Threshold
  • Cancer Survivors / statistics & numerical data
  • Cisplatin / adverse effects*
  • Follow-Up Studies
  • Hearing
  • Hearing Loss, High-Frequency / chemically induced
  • Hearing Loss, High-Frequency / epidemiology*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Ototoxicity / epidemiology*
  • Ototoxicity / etiology
  • Presbycusis / epidemiology*
  • Presbycusis / etiology
  • Self Report
  • Testicular Neoplasms / drug therapy*
  • Testicular Neoplasms / physiopathology


  • Antineoplastic Agents
  • Cisplatin