Original Articles
Video Head Impulse Test for the Patients Treated with Cisplatin
2024 Volume 83 Issue 4 Pages 199-207
Details
2024 Volume 83 Issue 4 Pages 199-207
Background: The relationship between cisplatin and vestibular function still remains controversial. Some clinical and animal studies have reported high-frequency vestibulo-ocular reflex (VOR) impairments induced by cisplatin. The video head impulse test (vHIT) may enable clinicians to detect the effects of cisplatin therapy in the high frequency range of the VOR.
Materials and Methods: The subjects were two males with laryngeal cancer and five females with uterine cervical cancer (mean age: 59.4 years) who received treatment with cisplatin. The vHIT and the subjective visual vertical (SVV) measured by the bucket method were examined before the start of cisplatin and after every cycle (weekly 40 mg/m2 or triweekly 80 mg/m2) of cisplatin-based therapy. Air conduction hearing was also evaluated in the patients with uterine cervical cancer.
Results: The group mean VOR did not differ significantly depending on the cumulative cisplatin dose in the range of 0 to 240 mg/m2. However, five and two patients exhibited an increase and decrease, respectively, of the VOR gain outside the normal range (0.8–1.2). Furthermore, two patients also exhibited covert catch-up saccades. The occurrence of covert saccades was not correlated with the VOR gain, but increased as the cumulative cisplatin dose increased. No significant change in the SVV was observed either during or after the treatment. The hearing levels fluctuated slightly. The ranges of fluctuation at 500 and 1000 Hz were smaller than that at other frequencies.
Conclusion: Cisplatin did not impair the functions of the semicircular canals at moderate doses, on average. However, some patients exhibited decrease and increase of the VOR gain and covert saccades. The increase in VOR gain and covert saccades was possibly associated with slight cisplatin-induced vestibulopathy or endolymphatic hydrops. vHIT is a simple tool to monitor the functions of the semicircular canals during and after cisplatin treatment.
