High frequency hearing thresholds and product distortion otoacoustic emissions in cystic fibrosis patients

Geyer, Lúcia Bencke; Barreto, Sérgio Saldanha Menna; Weigert, Liese Loureiro; Teixeira, Adriane Ribeiro

doi:10.1016/j.bjorl.2015.08.011

Cited by 17 publications

(20 citation statements)

References 43 publications

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“…A prospective study in adults investigated the ototoxic detection rate of DPOAEs and behavioural measures (HFA) and reported DPOAEs specificity rate was 78% in ears with confirmed behavioural changes and measurable DPOAEs [ 30 ]. A similar study in children with CF who received aminoglycosides showed higher alterations in HFA compared to DPOAEs [ 33 ]. In contrast, another study concluded that both HFA and DPOAEs showed the same sensitivity in detecting ototoxicity, but did not produce the same results in all patients [ 42 ].…”

Section: Diagnosismentioning

confidence: 94%

“…1 shows the proposed ototoxicity monitoring protocol. Most studies have found HFA is a more sensitive tool in the early identification of ototoxic changes than PTA [ 24 , 31 - 33 ]. Length of testing is the major limitation of behavioural threshold monitoring.…”

Section: Diagnosismentioning

confidence: 99%

“…An objective measure like DPOAEs is preferred for ototoxic monitoring compared to PTA in infants and non-responsive adults [ 39 - 41 ]. Few studies have examined the sensitivity of PTA, HFA, and DPOAE in the detection of ototoxicity [ 30 , 33 , 42 ]. A prospective study in adults investigated the ototoxic detection rate of DPOAEs and behavioural measures (HFA) and reported DPOAEs specificity rate was 78% in ears with confirmed behavioural changes and measurable DPOAEs [ 30 ].…”

Section: Diagnosismentioning

confidence: 99%

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Ototoxicity: A Challenge in Diagnosis and Treatment

Ganesan¹,

Schmiedge²,

et al. 2018

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Ototoxicity is the pharmacological adverse reaction affecting the inner ear or auditory nerve, characterized by cochlear or vestibular dysfunction. The panorama of drug-induced hearing loss has widened over last few decades. Although ototoxic medications play an imperative role in modern medicine, they have the capacity to cause harm and lead to significant morbidity. Evidence has shown early detection of toxicity through prospective ototoxicity monitoring allows for consideration of treatment modifications to minimize or prevent permanent hearing loss and balance impairment. Although many ototoxicity monitoring protocols exist, their practicality is questionable due to several factors. Even though the existing protocols have proven to be effective, certain lacunae in practice have been encountered due to discrepancies among recommended protocols. Implementation of these protocols is mostly held back due to the incapacitated status of the patient. The choice of early ototoxicity identification techniques is still debatable due to variables such as high degree of sensitivity, specificity and reliability, less time consumption and less labour-intensive to the patient. Hence, the diagnosis and effective treatment of ototoxicity is challenging, even today. A stringent protocol with more practicality encompassing all elements aimed at profiling the effects of ototoxicity is greatly needed. This review describes an efficient application of ototoxicity monitoring and treatment protocol as an attempt to reduce the challenges in diagnosis and management of ototoxicity.

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Section: Diagnosismentioning

confidence: 94%

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

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Ototoxicity: A Challenge in Diagnosis and Treatment

Ganesan¹,

Schmiedge²,

et al. 2018

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“…This drug is known to be cochleotoxic. 8 , 21 The incidence of hearing loss varies greatly and may depend on genetic factors, individual susceptibility, the type of assessment used, and the criteria established to define hearing loss. 10 Early detection of ototoxicity enables changes to be made to the drug regimen in order to stabilize damage to the structures of the ear and prevent further damage to them, thus reducing the chance of impaired psychosocial relationships due to impaired communication.…”

Section: Discussionmentioning

confidence: 99%

Sequential analysis as a tool for detection of amikacin ototoxicity in the treatment of multidrug-resistant tuberculosis

et al. 2018

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Objective:To investigate early detection of amikacin-induced ototoxicity in a population treated for multidrug-resistant tuberculosis (MDR-TB), by means of three different tests: pure-tone audiometry (PTA); high-frequency audiometry (HFA); and distortion-product otoacoustic emission (DPOAE) testing. Methods:This was a longitudinal prospective cohort study involving patients aged 18-69 years with a diagnosis of MDR-TB who had to receive amikacin for six months as part of their antituberculosis drug regimen for the first time. Hearing was assessed before treatment initiation and at two and six months after treatment initiation. Sequential statistics were used to analyze the results. Results:We included 61 patients, but the final population consisted of 10 patients (7 men and 3 women) because of sequential analysis. Comparison of the test results obtained at two and six months after treatment initiation with those obtained at baseline revealed that HFA at two months and PTA at six months detected hearing threshold shifts consistent with ototoxicity. However, DPOAE testing did not detect such shifts. Conclusions:The statistical method used in this study makes it possible to conclude that, over the six-month period, amikacin-associated hearing threshold shifts were detected by HFA and PTA, and that DPOAE testing was not efficient in detecting such shifts.

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“…15 Furthermore, extended high-frequency audiometry, which is more sensitive in detecting early ototoxic effects, is often not routinely performed. 16 There has hence been a technology drive to enable tablet, smartphone or web-based OMPs integrated within the clinical service to streamline care. Recent studies have validated this technology in healthy children and adults, but to date, there are no studies validating their use to detect hearing loss in adults with chronic lung disease.…”

Section: Why Read On?mentioning

confidence: 99%

Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis

Vijayasingam

Frost

Wilkins

et al. 2020

Thorax

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IntroductionIndividuals with chronic lung disease (eg, cystic fibrosis (CF)) often receive antimicrobial therapy including aminoglycosides resulting in ototoxicity. Extended high-frequency audiometry has increased sensitivity for ototoxicity detection, but diagnostic audiometry in a sound-booth is costly, time-consuming and requires a trained audiologist. This cross-sectional study analysed tablet-based audiometry (Shoebox MD) performed by non-audiologists in an outpatient setting, alongside home web-based audiometry (3D Tune-In) to screen for hearing loss in adults with CF.MethodsHearing was analysed in 126 CF adults using validated questionnaires, a web self-hearing test (0.5 to 4 kHz), tablet (0.25 to 12 kHz) and sound-booth audiometry (0.25 to 12 kHz). A threshold of ≥25 dB hearing loss at ≥1 audiometric frequency was considered abnormal. Demographics and mitochondrial DNA sequencing were used to analyse risk factors, and accuracy and usability of hearing tests determined.ResultsPrevalence of hearing loss within any frequency band tested was 48%. Multivariate analysis showed age (OR 1.127; (95% CI: 1.07 to 1.18; p value<0.0001) per year older) and total intravenous antibiotic days over 10 years (OR 1.006; (95% CI: 1.002 to 1.010; p value=0.004) per further intravenous day) were significantly associated with increased risk of hearing loss. Tablet audiometry had good usability, was 93% sensitive, 88% specific with 94% negative predictive value to screen for hearing loss compared with web self-test audiometry and questionnaires which had poor sensitivity (17% and 13%, respectively). Intraclass correlation (ICC) of tablet versus sound-booth audiometry showed high correlation (ICC >0.9) at all frequencies ≥4 kHz.ConclusionsAdults with CF have a high prevalence of drug-related hearing loss and tablet-based audiometry can be a practical, accurate screening tool within integrated ototoxicity monitoring programmes for early detection.

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High frequency hearing thresholds and product distortion otoacoustic emissions in cystic fibrosis patients

Cited by 17 publications

References 43 publications

Ototoxicity: A Challenge in Diagnosis and Treatment

Ototoxicity: A Challenge in Diagnosis and Treatment

Sequential analysis as a tool for detection of amikacin ototoxicity in the treatment of multidrug-resistant tuberculosis

Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis

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