Intratympanic N-Acetylcysteine for Prevention of Cisplatin-induced Ototoxicity.

Inclusion Criteria: * Advanced stage head and neck cancer * Receiving high dose systemic cisplatin (100mg/m2) with concurrent radiation therapy as part of their curative intent treatment * Willing to provide informed consent * ECOG performance status 0-2 * Histological confirmation of squamous cell carcinoma Exclusion Criteria: * Age less than 18 * Metastatic disease * Tympanic membrane perforation or the presence of tympanostomy tubes as this may impact the retention and absorption of NAC when inserted into the middle ear * Preexisting severe to profound sensorineural hearing loss (unilateral or bilateral) * Pretreatment interaural discrepancy of greater than 10dB at three frequencies * History of Meniere's or fluctuating hearing loss * Previous hypersensitivity to NAC * Patient unable to follow the protocol for any reason