Tesis

Perubahan Ambang Dengar dan Signal to Noise Ratio pada Pasien Pasca Kemoterapi Cisplatin serta Faktor-faktor yang Memengaruhi = Changes in Hearing Thresholds and Signal-to-noise ratio in Patients after Cisplatin Chemotherapy and the Influencing Factors.

Latar Belakang: Cisplatin dikenal memiliki efek ototoksik, terutama pada frekuensi tinggi. Penelitian mengenai dampaknya terhadap ambang dengar dan Signal to Noise Ratio (SNR), serta peran stadium kanker dan laju filtrasi glomerulus (LFG), masih terbatas. Tujuan: Menilai perubahan ambang dengar dan SNR setelah kemoterapi cisplatin, serta hubungannya dengan stadium kanker dan LFG. Metode: Penelitian kuasieksperimental longitudinal ini melibatkan 17 pasien kanker serviks yang menjalani kemoterapi cisplatin. Pemeriksaan audiometri dan DPOAE dilakukan sebelum kemoterapi, setelah pemberian pertama, dan kedua. Analisis menggunakan uji Friedman, repeated measures ANOVA, Kruskal-Wallis, dan korelasi Spearman. Hasil: Terdapat peningkatan ambang dengar dan penurunan SNR yang signifikan pada beberapa frekuensi (p < 0,05). Tidak ditemukan hubungan signifikan dengan stadium kanker, namun terdapat kecenderungan penurunan lebih berat pada stadium lanjut. Penurunan LFG berkorelasi positif dengan peningkatan ambang dengar pada frekuensi 1 0.000 Hz telinga kiri. Kesimpulan: Cisplatin menyebabkan gangguan pendengaran, terutama pada frekuensi tinggi. Stadium kanker dan LFG dapat memengaruhi derajat perubahan tersebut. Pemantauan pendengaran berkala dianjurkan untuk monitoring efek kemoterapi.
Kata kunci: cisplatin, ototoksisitas, audiometri, DPOAE, fungsi ginjal, stadium kanker, gangguan pendengaran


Background: Cisplatin is known to have ototoxic effects, particularly at high frequencies. Research on its impact on hearing thresholds and signal-to-noise ratio (SNR), as well as the roles of cancer staging and glomerular filtration rate (GFR), remains limited. Objective: To evaluate changes in hearing thresholds and SNR following cisplatin chemotherapy, and their association with cancer stage and GFR. Methods: This longitudinal quasi-experimental study involved 17 cervical cancer patients undergoing cisplatin chemotherapy. Pure-tone audiometry and DPOAE examinations were conducted before chemotherapy, after the first, and after the second administration. Data was analyzed using Friedman test, repeated measures ANOVA, Kruskal-Wallis test, and Spearman correlation. Results: There was a significant increase in hearing thresholds and a decrease in SNR at several frequencies (p < 0.05). No significant association was found with cancer stage, although more severe hearing loss was observed in advanced-stage cases. A significant positive correlation was found between GFR decline and increased hearing threshold at 10,000 Hz in the left ear. Conclusion: Cisplatin induces hearing impairment, especially at high frequencies. Cancer stage and GFR may influence the severity of hearing changes. Regular auditory monitoring is recommended to detect early effects of chemotherapy.
Keywords: cisplatin, ototoxicity, audiometry, DPOAE, renal function, cancer stage, hearing loss