Corticoids
Three investigations have evaluated the role of intratympanic corticosteroids to prevent CiO (Marshak et al., 2014, Moreno et al., 2022, Nasr et al., 2018). Two studies used dexamethasone and one methylprednisolone. In a controlled trial, prior to each cisplatin treatment session, intratympanic dexamethasone was injected 0.7 to 1.0 ml (10mg/ml) into randomly assigned ears. A significant attenuation in the hearing loss at 6000 Hz (P<0.02) and decreased outer hair dysfunction in the range of 4000 to 8000 Hz (P<0 .04) was observed in the intervention group (Marshak et al., 2014). These positive findings of intratympanic dexamethasone protecting the hearing capacity were corroborated by a second randomized controlled phase IIIB trial. Dexamethasone was administered via a passive diffusion device to an ear and the contralateral ear was used as the control. Audiometric analysis showed a higher hearing threshold in the study group than in the control group with significant differences at frequencies of 500, 1000, and 6000 Hz (p < 0.05)(Moreno et al. 2022). Safety outcomes for both trials reported slight pain and mild vertigo during the application, otological infections, and permanent tympanic perforation in 34.8% of the patients (Marshak et al., 2014, Moreno et al., 2022). Lastly, 0.3ml (40mg/ml) of intratympanic methylprednisolone was also assessed for CiO treatment in a prospective cohort of 20 patients with any type of cancer. Intratympanic corticosteroid injections appeared to have minimal therapeutic effect diminishing cisplatin‐induced hearing loss at 6000 and 8000 Hz. The adverse effects of this trial were not reported (Nasr et al., 2018).