A New Grading System for Ototoxicity in Adults

Abstract

The new criteria show an increased sensitivity to ototoxicity compared to CTCAEv4 and ASHA and provide insight into the effect of hearing loss on certain daily life situations. The new grading system seems feasible for clinic and research purposes.

Ototoxicity and cancer therapy

“…Several ototoxicity grading systems are currently in use (Table ) . Due to significant variability between grading scales, efforts are currently underway to develop expert consensus regarding a uniform ototoxicity grading method .…”

“…The accurate classification of hearing loss has implications for both the clinical management of patients and for the evaluation and comparison of audiologic outcomes on clinical trials . Across most scales, hearing loss is assigned a grade ranging from 0 (normal hearing, or clinically insignificant loss) to 4 (severe or profound hearing loss); however, there is significant variability in the definitions of the grades among the scales, and some scales are designed for use in children whereas others are designed for use in adult populations . In addition, there are classification systems designed to detect early ototoxicity that designate hearing solely as “normal” versus “impaired,” without assigning a severity grade …”

Current practice of ototoxicity management across the United Kingdom (UK)

“…Although ototoxicity may seem a small price to pay for curing malignancies or severe infections, patients may perceive a hearing loss as a major effect on daily functioning and quality of life (Theunissen et al 2014). Hearing loss at speech frequencies up to 4 kHz may result in a deterioration of speech intelligibility.…”

“…Hearing loss at speech frequencies up to 4 kHz may result in a deterioration of speech intelligibility. Hearing loss at higher frequencies (44 kHz) might have an adverse effect on the recognition and appreciation of sounds perceived in nature and music (birds, instruments, melodies) (Theunissen et al 2014). In addition to the consequences of the physical disability, considering the patient holistically is essential.…”

Challenges of Hearing Rehabilitation after Radiation and Chemotherapy

“…Several grading systems have been developed to grade the severity of hearing loss associated with chemotherapy in children and adults. [11][12][13][14]…”