High-frequency audiometry reveals high prevalence of aminoglycoside ototoxicity in children with cystic fibrosis

Abstract

CF children who had received at least 10 courses of IV AG had a higher risk of ototoxicity. EHF audiometry identified 2 more children with ototoxicity than standard PTA and depending on facilities available, should be the test of choice for detecting ototoxicity in children with CF receiving IV AG.

The role of routine hearing screening in children with cystic fibrosis on aminoglycosides: A systematic review

“…Of these initial 75 studies, 63 studies did not meet inclusion criteria and were excluded. A total of 12 articles were included in the final review (Table ) . Three of the 12 articles also studied adult CF patients.…”

“…All studies were carried out at single institutions except for Mulheran et al, which was a multicenter study. Eight of 12 studies (66.7%) utilized statistical analysis . A comprehensive overview of the studies is presented in Table .…”

“…From the five studies that utilized high‐frequency pure‐tone audiometry (HFPTA) in addition to standard PTA, three recommended HFPTA in addition to standard PTA as a means of screening . Of the four studies that utilized otoacoustic emissions (OAEs), all found DPOAEs to be at least as useful for screening as PTA . Three of these studies formally recommended DPOAEs as a screening measure .…”

“…Based on the high prevalence of SNHL in children with CF with a history of aminoglycoside exposure, routine hearing screenings should be implemented . The articles that made no recommendation either studied patients with low levels of exposure or reported no hearing loss over a short duration .…”

Aminoglycosides: old friend…new foe?

“…Although hearing loss is more likely in patients who have received multiple courses of aminoglycoside therapy, the nature of this relationship is likely to be non-linear and linked to other factors, such as age and lung function (5). The precise prevalence of ototoxicity is unclear as data are limited, but in one series (n=153) of adult CF patients, 50.8% had some evidence of auditory impairment (6).…”