Hearing thresholds at high frequency in patients with cystic fibrosis: a systematic review

Caumo, Débora Tomazi Moreira; Geyer, Lúcia Bencke; Teixeira, Adriane Ribeiro; Barreto, Sérgio Saldanha Menna

doi:10.1016/j.bjorl.2016.10.006

Cited by 3 publications

(1 citation statement)

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“…To date, literature on EHF hearing in children remains sparse and generally focused on hearing sensitivity. EHF hearing impairment can occur in children due to several causes, such as pressure equalization (PE) tube surgery for treating otitis media (OM) (Gravel et al 2006; Margolis et al 2000; Hunter et al 1996; Hunter et al 2021), ototoxicity from cystic fibrosis treatment (Al-Malky et al 2015; Blankenship et al 2021; Caumo et al 2017) or from heavy metal exposure (Shargorodsky et al 2011).…”

Section: Introductionmentioning

confidence: 99%

Hearing Impairment in the Extended High Frequencies in Children Despite Clinically Normal Hearing

2022

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Objectives: Pediatric hearing impairment, regardless of degree and type, has a detrimental effect on speech perception, cognition, oral language development, academic outcomes, and literacy. Hearing assessment in the clinic is limited to 8 kHz although humans can hear up to 20 kHz. Hearing impairment in the extended high frequencies (EHFs > 8 kHz) can occur despite clinically normal hearing. However, to date, the nature and effects of EHF hearing impairment in children remain unknown. The goals of the present study were to determine the effects of EHF hearing impairment on speech-in-noise recognition in children and to examine whether hearing impairment in the EHFs is associated with altered cochlear functioning in the standard frequencies.Design: A volunteer sample of 542 participants (4 to 19 years) with clinically normal audiograms were tested. Participants identified with EHF impairment were assigned as cases in a subsequent case-control study. EHF loss was defined as hearing thresholds greater than 20 dB in at least one EHFs (10, 12.5, or 16 kHz). Speech recognition thresholds in multi-talker babble were measured using the digit triplet test. Distortion product otoacoustic emissions (f 2 = 2, 3, 4, and 5 kHz) were measured to assess cochlear functioning.Results: Thresholds in the EHFs were as reliable as those in the standard frequency range. Thirty-eight children had EHF hearing impairment regardless of a clinically normal audiogram. A linear mixed-effects model revealed that children with EHF hearing impairment had higher (poorer) mean speech recognition threshold than children with normal EHF sensitivity (estimate = 2.14 dB, 95% CI: 1.36 to 3.92; effect size = small). The overall magnitude of distortion product otoacoustic emissions was lower for children with EHF impairment (estimate = -2.47 dB, 95% CI: -4.60 to -0.73; effect size = medium). In addition, the pure-tone average for standard audiometric frequencies was relatively higher for EHF-impaired children (estimate = 3.68 dB, 95% CI: 2.56 to 4.80; effect size = small).Conclusions: Hearing impairment in the EHFs is common in children despite clinically normal hearing and can occur without a history of otitis media. EHF impairment is associated with poorer speech-in-noise recognition and preclinical cochlear deficits in the lower frequencies where hearing thresholds are normal. This study highlights the clinical need to identify EHF impairments in children.

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Section: Introductionmentioning

confidence: 99%

Hearing Impairment in the Extended High Frequencies in Children Despite Clinically Normal Hearing

2022

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Ototoxicity in cystic fibrosis patients receiving intravenous tobramycin for acute pulmonary exacerbation

Harruff¹,

Kil²,

Ortiz

et al. 2021

Journal of Cystic Fibrosis

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Extended High-Frequency Audiometry for Ototoxicity Monitoring: A Longitudinal Evaluation of Drug-Resistant Tuberculosis Treatment

et al. 2023

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Purpose: The aim of this study was to describe extended high-frequency (EHF) pure-tone audiometry monitoring of ototoxicity in a longitudinal treatment program for drug-resistant tuberculosis (DRTB). Method: This was a retrospective record review of longitudinal conventional (0.25–8 kHz) and EHF (9–16 kHz) audiometry for ototoxicity monitoring of DRTB patients undergoing treatment at community-based clinics between 2013 and 2017. Data from 69 patients with an average age of 37.9 years ( SD = 11.2, range: 16.0–63.8 years) were included. Patients were assessed by primary health care audiologists (87%) or community health workers (13%) using portable audiological equipment. The average length of time between initial and exit assessments was 84.6 days ( SD = 74.2, range: 2–335 days). Results: EHF ototoxicity of a mild or greater degree of hearing loss (> 25 dB HL in one or both ears across frequencies) was evident in 85.5% of patients' posttreatment, compared with 47.8% of patients across conventional frequencies. EHF audiometry demonstrated an ototoxic shift (American Speech-Language-Hearing Association criteria) in 56.5% of cases compared with 31.9% when only conventional audiometry was considered. Mean hearing deterioration for patients was significant across EHFs (9–16 kHz) bilaterally ( p < .05). Absent EHF thresholds at the initial assessment, owing to maximum output limits, was a limitation that occurred most frequently at 16 kHz (17.4%, 24/138). Conclusions: EHF audiometry is most sensitive for the early detection of ototoxicity and should be included in monitoring programs. Clinical ototoxicity monitoring protocols should consider shortened assessment approaches that target frequencies most sensitive to ototoxicity, including EHFs. Supplemental Material: https://doi.org/10.23641/asha.21651242

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Hearing thresholds at high frequency in patients with cystic fibrosis: a systematic review

Abstract: The incidence of hearing loss was identified at high frequencies in cystic fibrosis patients without hearing complaints. It is assumed that high-frequency audiometry can be an early diagnostic method to be recommended for hearing investigation of patients at risk of ototoxicity.

Cited by 3 publications

References 35 publications

Hearing Impairment in the Extended High Frequencies in Children Despite Clinically Normal Hearing

Hearing Impairment in the Extended High Frequencies in Children Despite Clinically Normal Hearing

Ototoxicity in cystic fibrosis patients receiving intravenous tobramycin for acute pulmonary exacerbation

Extended High-Frequency Audiometry for Ototoxicity Monitoring: A Longitudinal Evaluation of Drug-Resistant Tuberculosis Treatment

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