High-frequency audiometry reveals high prevalence of aminoglycoside ototoxicity in children with cystic fibrosis
| Autor: | Tony Sirimanna, Emmanouil Bagkeris, R. Suri, Sally J. Dawson, Ghada Al-Malky |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Cystic Fibrosis Hearing loss Otoacoustic Emissions Spontaneous Audiology Risk Assessment Cystic fibrosis Ototoxicity Risk Factors otorhinolaryngologic diseases Tobramycin Humans Medicine Pediatrics Perinatology and Child Health Child Hearing Loss High prevalence medicine.diagnostic_test business.industry Aminoglycoside medicine.disease United Kingdom Aminoglycosides Pediatrics Perinatology and Child Health Audiometry Pure-Tone Administration Intravenous Female Pure tone audiometry medicine.symptom Audiometry business medicine.drug |
| Zdroj: | Journal of Cystic Fibrosis. 14:248-254 |
| ISSN: | 1569-1993 |
| DOI: | 10.1016/j.jcf.2014.07.009 |
| Popis: | Background Intravenous aminoglycoside (IV AG) antibiotics, widely used in patients with cystic fibrosis (CF), are known to have ototoxic complications. Despite this, audiological monitoring is not commonly performed and if performed, uses only standard pure-tone audiometry (PTA). The aim of this study was to investigate ototoxicity in CF children, to determine the most appropriate audiological tests and to identify possible risk factors. Methods Auditory assessment was performed in CF children using standard pure tone audiometry (PTA), extended high-frequency (EHF) audiometry and distortion-product otoacoustic emissions (DPOAE). Results 70 CF children, mean (SD) age 10.7 (3.5) years, were recruited. Of the 63 children who received IV AG, 15 (24%) children had ototoxicity detected by EHF audiometry and DPOAE. Standard PTA only detected ototoxicity in 13 children. Eleven of these children had received at least 10 courses of IV AG courses. A 25 to 85dBHL hearing loss (mean±SD: 57.5±25.7dBHL) across all EHF frequencies and a significant drop in DPOAE amplitudes at frequencies 4 to 8kHz were detected. However, standard PTA detected a significant hearing loss (>20dBHL) only at 8kHz in 5 of these 15 children and none in 2 subjects who had significantly elevated EHF thresholds. The number of courses of IV AG received, age and lower lung function were shown to be risk factors for ototoxicity. Conclusions 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. |
| Databáze: | OpenAIRE |
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