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Peerbhay N, Munsamy DR, Dlamini HP, Langa F, Paken J. The use of tele-audiology in ototoxicity monitoring: A scoping review. J Telemed Telecare 2024; 30:475-496. [PMID: 34989631 DOI: 10.1177/1357633x211068277] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Due to the growing burden of disease in South Africa, encompassing conditions such as tuberculosis, human immunodeficiency virus, and cancer, the holistic management of affected patients incorporating ototoxicity monitoring is a necessity. However, ototoxicity monitoring in developing countries may be limited due to a lack of resources and inadequate healthcare facilities. Subsequently, the use of tele-audiology may be a revolutionary technique with the potential to provide audiology services to under-served populations with limited access. METHODS The study aimed to describe the use of tele-audiology services in ototoxicity monitoring through a scoping review of English peer-reviewed articles from June 2009 to June 2020. Seventeen articles were purposively selected from the following databases: PubMed, Science Direct, Taylor and Francis Online, WorldCat, and Google Scholar. Data was extracted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram and results were analyzed using deductive thematic analysis. RESULTS AND DISCUSSION While a minority of the studies indicated that the cost of implementation and network connectivity within a South African context pose as barriers, most researchers reported that tele-audiology provides a reliable, time-efficient, cost-effective, and easily accessible alternative for ototoxicity monitoring. Hardware including the WAHTS, KUDUwave, and OtoID, along with software such as the TabSINT, Otocalc, uHear, and the hearTest, have proven to be useful for ototoxicity monitoring. A need for further investigations regarding the feasibility of tele-audiology implementation in South Africa is evident. Despite this, it provides audiologists with an opportunity to offer contact-less services during COVID-19, thus, confirming its versatility as an augmentative method for ototoxicity monitoring.
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Affiliation(s)
- Nazeera Peerbhay
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Danielle R Munsamy
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Hombisa P Dlamini
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Fisokuhle Langa
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Jessica Paken
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, South Africa
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Stout NL, Boatman D, Rice M, Branham E, Miller M, Salyer R. Unmet Needs and Care Delivery Gaps Among Rural Cancer Survivors. J Patient Exp 2024; 11:23743735241239865. [PMID: 38505492 PMCID: PMC10949551 DOI: 10.1177/23743735241239865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Community-based healthcare delivery systems frequently lack cancer-specific survivorship support services. This leads to a burden of unmet needs that is magnified in rural areas. Using sequential mixed methods we assessed unmet needs among rural cancer survivors diagnosed between 2015 and 2021. The Supportive Care Needs Survey (SCNS) assessed 5 domains; Physical and Daily Living, Psychological, Support and Supportive Services, Sexual, and Health Information. Needs were analyzed across domains by cancer type. Survey respondents were recruited for qualitative interviews to identify care gaps. Three hundred and sixty two surveys were analyzed. Participants were 85% White (n = 349) 65% (n = 234) female and averaged 2.03 years beyond cancer diagnosis. Nearly half (49.5%) of respondents reported unmet needs, predominantly in physical, psychological, and health information domains. Needs differed by stage of disease. Eleven interviews identified care gap themes regarding; Finding Support and Supportive Services and Health Information regarding Care Delivery and Continuity of Care. Patients experience persistent unmet needs after a cancer diagnosis across multiple functional domains. Access to community-based support services and health information is lacking. Community based resources are needed to improve access to care for long-term cancer survivors.
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Affiliation(s)
- Nicole L Stout
- Department of Cancer Prevention and Control, School of Medicine, West Virginia University, Morgantown, WV, USA
- Department of Health Policy, Management, and Leadership, School of Public, West Virginia University, Morgantown, WV, USA
| | - Dannell Boatman
- Department of Cancer Prevention and Control, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Madeline Rice
- Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Emelia Branham
- Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, WV, USA
| | | | - Rachel Salyer
- Department of Internal Medicine, School of Medicine, West Virginia University, Morgantown, WV, USA
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Chen L, Li J, Li K, Hu J, Li Q, Huang C, Wang G, Liu N, Tang L. Evaluation and analysis of risk factors of hearing impairment for nasopharyngeal carcinoma treated using intensity-modulated radiotherapy. Radiother Oncol 2024; 190:109985. [PMID: 37926330 DOI: 10.1016/j.radonc.2023.109985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/09/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Treating nasopharyngeal carcinoma (NPC) with radiotherapy frequently causes hearing impairment (HI). HI risk data haven't been evaluated quantitatively. This study aimed to analyze the probability of HI and sever HI (SHI), develop a nomogram to quantify individual prediction, and provide dose limitation suggestions. METHODS AND MATERIALS This single-center, retrospective study was conducted based on 588 adolescents and young adults with non-metastatic NPC treated using intensity modulated radiation therapy (IMRT) at Sun Yat-sen University Cancer Center between 2010 and 2016. A least absolute shrinkage and selection operator (LASSO) logistic regression model and univariate analysis were used to screen potential risk factors. The concordance index and a calibration curve evaluated the nomogram models' predictive ability, with bootstrap resampling validation. RESULTS We analyzed 588 patients with NPC, with a median follow-up of 103.4 months. HI occurred in 39.5 % of patients, with 29.7 % experiencing SHI. Two factors were classified as precursors for HI (volume 45 Gy of the inner ear (IEV45) and volume 50 Gy of the internal auditory canal (IACV50)), and IACmin and IACV60 for SHI, respectively. Prognostic nomograms were developed to predict HI and SHI probabilities, showing excellent discriminative abilities (c-index values = 0.806 and 0.793, respectively). We also suggested IEV45 < 50 % and/or IACV50 < 40 % as rational dose limitations for HI, and IACmin < 44 Gy and/or the IACV60 < 40 % for SHI. CONCLUSION Comprehensive analysis could predict the risk of HI and SHI in NPC after IMRT, proposing rational dose limitations and improving long-term quality of life.
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Affiliation(s)
- Lin Chen
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China
| | - Jing Li
- Department of Oncology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518107, PR China
| | - Kunpeng Li
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China
| | - Jiang Hu
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, PR China
| | - Qingjie Li
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China; Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China
| | - Chenglong Huang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China
| | - Gaoyuan Wang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China
| | - Na Liu
- Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China.
| | - Linglong Tang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China.
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Gambacorta V, Orzan E, Faralli M, Gullà M, Lapenna R, Baietta I, De Angelis V, Ricci G. Practice of Monitoring Cisplatin-Induced Ototoxicity by Audiology, ENT, and Oncology Specialists: A Survey-Based Study in a Single Italian Medical Center. Audiol Res 2023; 13:779-790. [PMID: 37887850 PMCID: PMC10604261 DOI: 10.3390/audiolres13050069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
Ototoxic drugs can result in hearing loss and tinnitus. Early detection of the ototoxic process can help minimize or prevent these consequences. The American Speech-Language-Hearing Association has provided guidelines for monitoring ototoxicity, whereas Italy has not yet implemented a national monitoring protocol. This study aims to assess the current state of ototoxicity monitoring in patients receiving cisplatin therapy. A self-administered survey has been used to gather information from oncologists, audiologists, and ENT specialists. The research was conducted at Santa Maria della Misericordia hospital in Perugia. Two questionnaires were administered, one to ENT/audiology specialists and another to oncology specialists. Both questionnaires were used to collect information on awareness of chemotherapy-induced ototoxicity. A comprehensive understanding of cisplatin-induced ototoxicity has been widely established (100%). The most commonly reported audiological symptoms by patients were hearing loss (100%) and tinnitus (87.5%). The majority of ENT and audiologists (93.8%) and oncologists (92.9%) expressed the need for a specific ototoxic monitoring program. However, they noted the absence of a well-defined ototoxicity monitoring protocol. A well-established and efficient ototoxic monitoring system facilitates early detection of ototoxic hearing loss and subsequent rehabilitation of inevitable hearing impairment.
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Affiliation(s)
- Valeria Gambacorta
- Department of Medicine & Surgery, Section of Otorhinolaryngology, University of Perugia, 06126 Perugia, Italy; (V.G.)
| | - Eva Orzan
- Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Mario Faralli
- Department of Medicine & Surgery, Section of Otorhinolaryngology, University of Perugia, 06126 Perugia, Italy; (V.G.)
| | - Mario Gullà
- Department of Medicine & Surgery, Section of Otorhinolaryngology, University of Perugia, 06126 Perugia, Italy; (V.G.)
| | - Ruggero Lapenna
- Department of Medicine & Surgery, Section of Otorhinolaryngology, University of Perugia, 06126 Perugia, Italy; (V.G.)
| | - Irene Baietta
- Department of Medicine & Surgery, Section of Otorhinolaryngology, University of Perugia, 06126 Perugia, Italy; (V.G.)
| | - Verena De Angelis
- Clinical Oncology, Santa Maria della Misericordia Hospital, University of Perugia, 06126 Perugia, Italy
| | - Giampietro Ricci
- Department of Medicine & Surgery, Section of Otorhinolaryngology, University of Perugia, 06126 Perugia, Italy; (V.G.)
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Madaule J, Valenzuela F, Mittaine M, Gallois Y, Baladi B, Murris M, Calmels MN, Concordet D, Gandia P. Exploration of the relationship between cumulative exposure to tobramycin and ototoxicity in patients with cystic fibrosis. J Cyst Fibros 2023; 22:944-948. [PMID: 37088635 DOI: 10.1016/j.jcf.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Aminoglycosides (AGs), such as tobramycin, are essential antibiotics in the management of pulmonary infections in patients with cystic fibrosis (CF). They induce ototoxicity without the relationship being clearly described in the literature. Our aim is to propose a mathematical and statistical model describing the relationship between the estimated cumulative exposure (Area Under the Curve, AUC) to tobramycin and ototoxicity with audiogram interpretation in young patients with CF. METHODS Cumulative AUCs were estimated for each course of tobramycin, for the 106 individuals with CF (between 4 and 22 years of age) enrolled in this retrospective study (35 who had received IV tobramycin, 71 controls). Mean hearing loss was calculated for each audiogram and a statistical model was developed to predict hearing loss. RESULTS The model confirms a significant relationship between cumulative tobramycin exposure and changes in hearing acuity: Meanhearingloss=2.7+(3×10-5)×AUC_tobramycin+individual_susceptibility However, the ototoxic effect is not clinically perceptible (mean hearing loss: 3.8 dB). The impact of AUC on hearing loss is minor in these subjects who received a limited number of courses of tobramycin (median: 5 courses). CONCLUSION A significant relationship between cumulative exposure to tobramycin and ototoxicity was demonstrated. Individual treatment susceptibility should not be overlooked. As ototoxicity is not clinically perceptible in the study subjects, hearing tests should be continued during adulthood to provide individualized medical guidance and to obtain a lifetime analysis of the relationship between exposure and hearing loss.
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Affiliation(s)
- Justine Madaule
- Pharmacokinetics and Toxicology Laboratory, Toulouse University Hospital, France
| | - Félix Valenzuela
- ENT, Otoneurology and Paediatric ENT, Toulouse University Hospital, France
| | - Marie Mittaine
- Paediatrics - Pulmonology and Allergology, Toulouse University Hospital, France; Cystic Fibrosis Resources and Competence Centre, Toulouse University Hospital, France
| | - Yohan Gallois
- ENT, Otoneurology and Paediatric ENT, Toulouse University Hospital, France
| | - Blandine Baladi
- ENT, Otoneurology and Paediatric ENT, Toulouse University Hospital, France; Cystic Fibrosis Resources and Competence Centre, Toulouse University Hospital, France
| | - Marlène Murris
- Adult Cystic Fibrosis Center, Pulmonology, CHU Toulouse, France
| | - Marie-Noelle Calmels
- ENT, Otoneurology and Paediatric ENT, Toulouse University Hospital, France; Cystic Fibrosis Resources and Competence Centre, Toulouse University Hospital, France
| | - Didier Concordet
- INTHERES (Therapeutic Innovation and Resistance), Toulouse University, INRAE (French National Research Institute for Agriculture, Food and Environment), ENVT (National Veterinary School of Toulouse), France
| | - Peggy Gandia
- Pharmacokinetics and Toxicology Laboratory, Toulouse University Hospital, France; INTHERES (Therapeutic Innovation and Resistance), Toulouse University, INRAE (French National Research Institute for Agriculture, Food and Environment), ENVT (National Veterinary School of Toulouse), France
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Zitelli L, Palmer C, Mamula E, Johnson J, Rauterkus G, Nilsen ML. Hearing screening and amplifier uptake results in a multidisciplinary head and neck cancer survivorship clinic. J Cancer Surviv 2023; 17:720-728. [PMID: 35348995 PMCID: PMC11186601 DOI: 10.1007/s11764-022-01198-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/28/2021] [Indexed: 10/18/2022]
Abstract
PURPOSE Hearing loss and tinnitus are prevalent among survivors of head and neck cancer (HNC), but auditory issues are under-addressed in the survivorship literature. The purpose of this study was to describe the hearing loss and management experience of a group of survivors provided with a hearing screening and amplifier assistance if needed during their visit. METHODS A retrospective chart review of 1176 individuals seen in the HNC Survivorship Clinic between December 2016 and October 2020 who interacted with audiology was performed. RESULTS Of these survivors, 72% failed the 30-dB HL hearing screening at one or more frequencies. Thirty-three percent of the sample reported tinnitus. Consistent with the general population, this group has a low prevalence of hearing aid use. In this clinic, individuals who fail the hearing screening at all frequencies are offered a simple, non-custom amplifier for use during their visit. Thirty-one percent of individuals offered the amplifier used it during their Survivorship Clinic visit to enhance communication and reduce listening effort. Only 54% of individuals who failed the hearing screening self-reported hearing loss. The poor sensitivity and specificity associated with the self-perception of hearing loss data support the need for hearing screening that consists of responding to tones. Of individuals who received a recommendation for a comprehensive hearing test, 21% received a hearing test with 68% of these individuals receiving the hearing test the same day of their Survivorship Clinic visit. CONCLUSIONS The data from 1176 survivors of HNC seen by audiology over the past few years as part of the UPMC HNC Survivorship Clinic support the need for hearing management in this population to improve communication during and after the Survivorship Clinic visit. IMPLICATIONS FOR CANCER SURVIVORS Survivors of HNC have a high prevalence of greater than mild hearing loss and tinnitus (both issues known to negatively impact health-related communication and quality of life). This manuscript describes a hearing screening program within a Survivorship Clinic that identifies individuals in need of non-custom amplification during their appointment to support effective communication. Survivors should be referred to audiologists for evaluation and management of treatment-related issues of hearing.
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Affiliation(s)
- Lori Zitelli
- UPMC, 203 Lothrop St., 4th Floor, Pittsburgh, PA, 15213, USA.
- University of Pittsburgh, Pittsburgh, PA, USA.
| | - Catherine Palmer
- UPMC, 203 Lothrop St., 4th Floor, Pittsburgh, PA, 15213, USA
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jonas Johnson
- UPMC, 203 Lothrop St., 4th Floor, Pittsburgh, PA, 15213, USA
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Marci L Nilsen
- UPMC, 203 Lothrop St., 4th Floor, Pittsburgh, PA, 15213, USA
- University of Pittsburgh, Pittsburgh, PA, USA
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Phillips OR, Baguley DM, Pearson SE, Akeroyd MA. The long-term impacts of hearing loss, tinnitus and poor balance on the quality of life of people living with and beyond cancer after platinum-based chemotherapy: a literature review. J Cancer Surviv 2023; 17:40-58. [PMID: 36637633 PMCID: PMC9971148 DOI: 10.1007/s11764-022-01314-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/07/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE To elucidate the long-term impacts of hearing loss, tinnitus and balance in people living with and beyond cancer (LWBC) treated with platinum-based chemotherapy (PBCT). METHODS A literature search was conducted between March and June 2022 using PubMed, Web of Science and Google Scholar. Full-text papers in English were included. Articles explored the impacts of hearing loss, tinnitus and balance and discussed them in the context of treatment. If PBCT was used in conjunction with other treatments, the article was included. There were no constraints on age, cancer type, publication date, location, study design or data type. Sixteen studies and two reviews were included. RESULTS Hearing loss and tinnitus can cause communication difficulties and subsequent social withdrawal. There were deficits in cognition, child development and educational performance. Employment and the ease of everyday life were disrupted by hearing loss and tinnitus, whereas poor balance interfered with walking and increased the risk of falls. Depression and anxiety were related to ototoxicity. Most notable were the differing mindsets experienced by adults LWBC with ototoxicity. There was evidence of inadequate monitoring of ototoxicity by clinicians and a lack of communication between clinicians and patients about ototoxicity as a side effect. CONCLUSIONS Ototoxicity has a negative long-term impact on multiple areas of life for adults and children LWBC. This can compromise their quality of life. IMPLICATIONS FOR CANCER SURVIVORS Increased awareness, monitoring and education surrounding these issues may lead to earlier intervention and better management of ototoxicity, enhancing the quality of life of people LWBC.
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Affiliation(s)
- Olivia R Phillips
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK
- NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - David M Baguley
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK
- NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Stephanie E Pearson
- The University of Nottingham Health Service, Cripps Health Centre, University Park, Nottingham, NG7 2QW, UK
| | - Michael A Akeroyd
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK.
- NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.
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Ehlert K, Heinze B, Graham MA, Swanepoel DW. Changes in vestibular and cochlear function following platinum-based chemotherapy: A preliminary report. EAR, NOSE & THROAT JOURNAL 2022:1455613221115042. [PMID: 36052943 DOI: 10.1177/01455613221115042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES This study investigated the changes in vestibular and cochlear function in patients receiving platinum-based chemotherapy. METHODS A longitudinal study of 32 participants (10-70 years) receiving chemotherapy participated in the study. Baseline and exit vestibular and hearing assessments that included video head impulse (VHIT) testing, cervical and ocular vestibular evoked myogenic potentials (VEMP), dynamic visual acuity (DVA) and pure-tone audiometry were performed at the patient's treatment venue. RESULTS Half (50%) of the participants showed cochleotoxicity from baseline to exit testing, with left ears significantly more affected than right ears. There was no consistent relationship between hearing loss and vestibular dysfunction. DVA yielded normal results at baseline and exit testing in all participants. VEMP responses were absent in 28.1% of participants at baseline, reflecting the challenges of using VEMP for monitoring. VEMP and VHIT results showed a statistically significant (p < 0.05) decline in results from baseline to exit testing; however, participants did not report symptoms related to vestibular dysfunction. VHIT also showed left ears significantly (p < 0.05) more affected than right ears. CONCLUSION VHIT proved to be a valuable measure of changes in vestibular function secondary to ototoxicity. Future investigations should determine vestibulotoxicity criteria and optimal protocols for vestibulotoxicity monitoring at the patient's treatment venue.
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Affiliation(s)
- Katerina Ehlert
- Department Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department Speech-Language Pathology and Audiology, Sefako Makgatho Health Sciences University, South Africa
| | - Barbara Heinze
- Department Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, WA, Australia
| | - Marien A Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - De Wet Swanepoel
- Department Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
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Paken J, Govender CD, Pillay M, Sewram V. Cisplatin-associated ototoxicity: perspectives from a single institution cervical cancer cohort and implications for developing a locally responsive monitoring programme in a public healthcare setting. BMC Health Serv Res 2022; 22:791. [PMID: 35717191 PMCID: PMC9206275 DOI: 10.1186/s12913-022-08099-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background Ototoxicity monitoring is uncommon in South Africa, despite the increased use of ototoxic medication to manage the burden of disease in the country. The successful implementation of such a protocol requires cognisance of contextual realities and multiple dimensions for consideration from both patients and service providers. As part of an ongoing cohort study on cisplatin-associated ototoxicity and efforts to better inform the implementation of such programmes, the perspectives of cervical cancer patients and healthcare workers towards ototoxicity monitoring were assessed. Methods This concurrent-triangulation mixed-methods study was conducted at a tertiary hospital in South Africa. Self-reported questionnaires from patients (n = 80) and healthcare personnel comprising clinicians, oncology nurses, pharmacists, and radiotherapists (n = 32), results of audiological evaluations, researcher field notes, and estimated patient and service provider costs contributed to data for this study. Data analysis included descriptive statistics, comparison of test characteristics and deductive thematic analysis. Results The ototoxicity monitoring programme was positively received by the participants, with 90.6% of healthcare personnel and 89% of patients reporting it to be beneficial. The clinicians (76.6%) were identified as the main providers of information on the effects of chemotherapy medication and made the necessary referrals for audiological evaluation. The approximate cost of setting up such a programme included purchase of equipment (US56 700) and the appointment of an audiologist (US 26 250). The approximate costs to patients included transport costs (US$ 38) and the loss of income for the day (US 60), calculated at the minimum wage per hour, if employed. Creative appointment scheduling, easy facility access and detailed locally comprehensible couselling improved patient compliance to the programme. Whilst the sequential use of American Speech-Language-Hearing Association (ASHA) and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) criteria aided in an evidence-informed approach to aural rehabilitation, DPOAEs and speech discrimination displayed low sensitivity (range 1.45% – 22.39%) but high specificity (range 77.78% – 100%) when identifying ototoxic change. Conclusion This novel study, through a ‘real-world’ experience, has revealed that an ototoxicity monitoring programme is feasible in South Africa, through meaningful engagements with- and considerations from- patients and service providers regarding planning, delineation of responsibilities and cost implications. The findings can potentially serve as a roadmap for other limited resource environments. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08099-8.
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Affiliation(s)
- Jessica Paken
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000, South Africa.
| | - Cyril D Govender
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000, South Africa
| | - Mershen Pillay
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000, South Africa.,Speech and Language Therapy, Massey University, Albany (Oteha Rohe) Campus, Building 84, Auckland, New Zealand
| | - Vikash Sewram
- African Cancer Institute, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town, 8000, South Africa.
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Aggarwal P, Nader M, Gidley PW, Pratihar R, Jivani S, Garden AS, Mott FE, Goepfert RP, Ogboe CW, Charles C, Fuller CD, Lai SY, Gunn GB, Sturgis EM, Hanna EY, Hutcheson KA, Shete S. Association of hearing loss and tinnitus symptoms with health-related quality of life among long-term oropharyngeal cancer survivors. Cancer Med 2022; 12:569-583. [PMID: 35695117 PMCID: PMC9844619 DOI: 10.1002/cam4.4931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/28/2022] [Accepted: 05/02/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This study investigated the association of hearing loss and tinnitus with overall health-related quality of life (HRQoL) among long-term oropharyngeal cancer (OPC) survivors. METHODS This study included OPC survivors treated between 2000 and 2013 and surveyed from September 2015 to July 2016. Hearing loss and tinnitus were measured by asking survivors to rate their "difficulty with hearing loss and/or ringing in the ears" from 0 (not present) to 10 (as bad as you can imagine). Hearing loss and tinnitus scores were categorized as follows: 0 for none, 1-4 for mild, and 5-10 for moderate to severe. The primary outcome was the mean score of MD nderson Symptom Inventory Head & Neck module interference component as a HRQoL surrogate dichotomized as follows: 0 to 4 for none to mild and 5 to 10 for moderate to severe interference. RESULTS Among 880 OPC survivors, 35.6% (314), reported none, 39.3% (347) reported mild, and 25.1% (221) reported moderate to severe hearing loss and tinnitus. On multivariable analysis, mild (OR, 5.83; 95% CI; 1.48-22.88; p = 0.012) and moderate (OR, 30.01; 95% CI; 7.96-113.10; p < 0.001) hearing loss and tinnitus were associated with higher odds of reporting moderate to severe symptom interference scores in comparison to no hearing loss and tinnitus. This association of hearing dysfunction was consistent with all domains of HRQoL. CONCLUSIONS Our findings provide preliminary evidence to support the need for continued audiological evaluations and surveillance to detect hearing dysfunction, to allow for early management and to alleviate the long-term impact on QoL.
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Affiliation(s)
- Puja Aggarwal
- Department of EpidemiologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Marc‐Elie Nader
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Paul W. Gidley
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Raj Pratihar
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Shirin Jivani
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Adam S. Garden
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Frank E. Mott
- Department of Thoracic Head and Neck Medical OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Ryan P. Goepfert
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | | | - Camille Charles
- Department of EpidemiologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Clifton D. Fuller
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Stephen Y. Lai
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA,Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - G. Brandon Gunn
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Erich M. Sturgis
- Department of Otolaryngology‐Head and Neck SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Ehab Y. Hanna
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Katherine A. Hutcheson
- Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA,Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Sanjay Shete
- Department of EpidemiologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA,Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHoustonTexasUnited States,Division of Cancer Prevention and Population SciencesThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
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11
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Moore BCJ, Lowe DA, Cox G. Guidelines for Diagnosing and Quantifying Noise-Induced Hearing Loss. Trends Hear 2022; 26:23312165221093156. [PMID: 35469496 PMCID: PMC9052822 DOI: 10.1177/23312165221093156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This paper makes recommendations for the diagnosis and quantification of noise-induced hearing loss (NIHL) in a medico-legal context. A distinction is made between NIHL produced by: steady broadband noise, as occurs in some factories; more impulsive factory sounds, such as hammering; noise exposure during military service, which can involve very high peak sound levels; and exposure to very intense tones. It is argued that existing diagnostic methods, which were primarily developed to deal with NIHL produced by steady broadband noise, are not adequate for the diagnosis of NIHL produced by different types of exposures. Furthermore, some existing diagnostic methods are based on now-obsolete standards, and make unrealistic assumptions. Diagnostic methods are proposed for each of the types of noise exposure considered. It is recommended that quantification of NIHL for all types of exposures is based on comparison of the measured hearing threshold levels with the age-associated hearing levels (AAHLs) for a non-noise exposed population, as specified in ISO 7029 (2017), usually using the 50th percentile, but using another percentile if there are good reasons for doing so. When audiograms are available both soon after the end of military service and some time afterwards, the most recent audiogram should be used for diagnosis and quantification, since this reflects any effect of the noise exposure on the subsequent progression of hearing loss. It is recommended that the overall NIHL for each ear be quantified as the average NIHL across the frequencies 1, 2, and 4 kHz.
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Affiliation(s)
- Brian C J Moore
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, UK
| | - David A Lowe
- ENT Department, 156705James Cook University Hospital, Cleveland, UK
| | - Graham Cox
- ENT Department (retired), 6397Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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12
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Belinsky I, Creighton FX, Mahoney N, Petris CK, Callahan AB, Campbell AA, Kazim M, Lee HBH, Yoon MK, Dagi Glass LR. Teprotumumab and Hearing Loss: Case Series and Proposal for Audiologic Monitoring. Ophthalmic Plast Reconstr Surg 2022; 38:73-78. [PMID: 34085994 DOI: 10.1097/iop.0000000000001995] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To present a protocol for audiologic monitoring in the setting of teprotumumab treatment of thyroid eye disease, motivated by 4 cases of significant hearing loss, and review the relevant literature. METHODS Cases of hearing loss in the setting of teprotumumab were retrospectively elicited as part of a multi-institutional focus group, including oculoplastic surgeons, a neurotologist and an endocrinologist. A literature review was performed. RESULTS An aggregate of 4 cases of teprotumumab-associated hearing loss documented by formal audiologic testing were identified among 3 clinicians who had treated 28 patients. CONCLUSIONS Teprotumumab may cause a spectrum of potentially irreversible hearing loss ranging from mild to severe, likely resulting from the inhibition of the insulin-like growth factor-1 and the insulin-like growth factor-1 receptor pathway. Due to the novelty of teprotumumab and the lack of a comprehensive understanding of its effect on hearing, the authors endorse prospective investigations of hearing loss in the setting of teprotumumab treatment. Until the results of such studies are available, the authors think it prudent to adopt a surveillance protocol to include an audiogram and tympanometry before, during and after infusion, and when prompted by new symptoms of hearing dysfunction.
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Affiliation(s)
- Irina Belinsky
- Department of Ophthalmology, New York University Langone Health, New York, New York
| | | | - Nicholas Mahoney
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins, Baltimore, Maryland
| | - Carisa K Petris
- Department of Ophthalmology, University of Missouri, Columbia, Missouri
| | - Alison B Callahan
- Department of Ophthalmology, Tufts University Medical Center, Boston, Massachusetts
| | - Ashley A Campbell
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins, Baltimore, Maryland
| | - Michael Kazim
- Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| | - H B Harold Lee
- Oculofacial Plastic and Orbital Surgery, Indianapolis, Indiana
| | - Michael K Yoon
- Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | - Lora R Dagi Glass
- Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
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13
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Clark KD, Garinis AC, Konrad-Martin D. Incorporating Patient Narratives to Enhance Audiological Care and Clinical Research Outcomes. Am J Audiol 2021; 30:916-921. [PMID: 34410834 DOI: 10.1044/2021_aja-20-00228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose The engagement of patients as key stakeholders in their experience of care processes is a critical component of quality improvement efforts for both clinical care and translational research. Increasingly, health care systems are soliciting input from patients on care processes and experiences through surveys, patient interviews, and patient video narratives. The purpose of this viewpoint article is twofold: (a) to describe the increasing role of patient narratives about their experiences with adverse health conditions to inform patient-centered research and quality improvement efforts and (b) to present three patient narratives that highlight the real-world impacts of hearing loss and tinnitus, the life enhancing impacts of aural rehabilitation, and the importance of prospective ototoxicity monitoring in individuals with complex health conditions. Conclusion Patient narratives provide individual patient perspectives that can be used to build awareness of the range of experiences and impact of hearing disorders, and to explore patient preferences for when and how to implement hearing-related clinical services.
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Affiliation(s)
- Khaya D. Clark
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Hearing Center of Excellence, Department of Defense, San Antonio, TX
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Angela C. Garinis
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
- Oregon Hearing Research Center, Oregon Health & Science University, Portland
| | - Dawn Konrad-Martin
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
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14
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Garinis AC, Poling GL, Rubenstein RC, Konrad-Martin D, Hullar TE, Baguley DM, Burrows HL, Chisholm JA, Custer A, Hawe LD, Hunter LL, Marras TK, Ortiz CE, Petersen L, Steyger PS, Winthrop K, Zettner EM, Clark K, Hungerford M, Vachhani JJ, Brewer CC. Clinical Considerations for Routine Auditory and Vestibular Monitoring in Patients With Cystic Fibrosis. Am J Audiol 2021; 30:800-809. [PMID: 34549989 PMCID: PMC9126110 DOI: 10.1044/2021_aja-21-00031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/09/2021] [Accepted: 05/24/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose Specific classes of antibiotics, such as aminoglycosides, have well-established adverse events producing permanent hearing loss, tinnitus, and balance and/or vestibular problems (i.e., ototoxicity). Although these antibiotics are frequently used to treat pseudomonas and other bacterial infections in patients with cystic fibrosis (CF), there are no formalized recommendations describing approaches to implementation of guideline adherent ototoxicity monitoring as part of CF clinical care. Method This consensus statement was developed by the International Ototoxicity Management Working Group (IOMG) Ad Hoc Committee on Aminoglycoside Antibiotics to address the clinical need for ototoxicity management in CF patients treated with known ototoxic medications. These clinical protocol considerations were created using consensus opinion from a community of international experts and available evidence specific to patients with CF, as well as published national and international guidelines on ototoxicity monitoring. Results The IOMG advocates four clinical recommendations for implementing routine and guideline adherent ototoxicity management in patients with CF. These are (a) including questions about hearing, tinnitus, and balance/vestibular problems as part of the routine CF case history for all patients; (b) utilizing timely point-of-care measures; (c) establishing a baseline and conducting posttreatment evaluations for each course of intravenous ototoxic drug treatment; and (d) repeating annual hearing and vestibular evaluations for all patients with a history of ototoxic antibiotic exposure. Conclusion Increased efforts for implementation of an ototoxicity management program in the CF care team model will improve identification of ototoxicity signs and symptoms, allow for timely therapeutic follow-up, and provide the clinician and patient an opportunity to make an informed decision about potential treatment modifications to minimize adverse events. Supplemental Material https://doi.org/10.23641/asha.16624366.
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Affiliation(s)
- Angela C. Garinis
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland
- Oregon Hearing Research Center, Oregon Health & Science University, Portland
| | - Gayla L. Poling
- Department of Otolaryngology — Head and Neck Surgery, Division of Audiology, Mayo Clinic, Rochester, MN
| | - Ronald C. Rubenstein
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University in St. Louis School of Medicine, MO
| | - Dawn Konrad-Martin
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Timothy E. Hullar
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland
| | - David M. Baguley
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, United Kingdom
- National Institute for Health Research Biomedical Research Centre, University of Nottingham, United Kingdom
| | - Holly L. Burrows
- Audiology and Speech Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Jennifer A. Chisholm
- Otolaryngology Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD
| | - Amy Custer
- Department of Audiology, The Ohio State University Comprehensive Cancer Hospital–Arthur G. James Cancer Hospital and Richard J. Solve Research Institute, Columbus
| | - Laura Dreisbach Hawe
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| | - Lisa L. Hunter
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, OH
| | - Theodore K. Marras
- Division of Respiratory Medicine, Toronto Western Hospital, University Health Network and University of Toronto, Canada
| | - Candice E. Ortiz
- Audiology and Speech Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Lucretia Petersen
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Peter S. Steyger
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Translational Hearing Center, Biomedical Sciences, Creighton University, Omaha, NE
| | - Kevin Winthrop
- School of Public Health, Oregon Health & Science University, Portland
| | - Erika M. Zettner
- Department of Otolaryngology-Head & Neck Surgery, Division of Audiology, University of California, San Diego
| | - Khaya Clark
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Hearing Center of Excellence, Department of Defense, San Antonio, TX
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Michelle Hungerford
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - Jay J. Vachhani
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - Carmen C. Brewer
- Otolaryngology Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD
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15
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Konrad-Martin D, O'Connell Bennett K, Garinis A, McMillan GP. A Randomized Controlled Trial Using Automated Technology for Improving Ototoxicity Monitoring in VA Oncology Patients. Am J Audiol 2021; 30:870-886. [PMID: 34582263 DOI: 10.1044/2021_aja-21-00032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Purpose Determine the efficacy of ototoxicity monitoring (OM) administered as automated protocols with the Oto-ID mobile audiometer (automated ototoxicity monitoring [A-OM]), compared with usual care (UC) OM in cancer patients receiving cisplatin. Method Participants were patients (n = 46, mean age 64.7 years; range: 30-78 years) receiving cisplatin-based chemotherapy at the Department of Veterans Affairs Portland Health Care System. A randomized controlled trial contrasted A-OM and UC at up to three program evaluations (PEs) conducted by the study audiologist who was blinded to arm through PE1. PE1 occurred before randomization or oncology treatment; PE2 and PE3 occurred during and/or after treatment at 35 and 365 days postrandomization. The A-OM group (n = 24) used Oto-ID to screen their hearing before each cisplatin dose. Oto-ID results were sent to the study audiologist for interpretation, follow-up, and care coordination. The UC group (n = 22) received a consult for OM services through the audiology clinic. Outcomes included hearing shift near each patient's high-frequency hearing limit, revised hearing-handicap inventory score, and survival time from the start of treatment. Adherence to OM protocols, patients' use of aural rehabilitation services, and oncologists' treatment decisions were also examined. Results Ototoxicity was identified at a high overall rate (46% and 76% at 35 and 365 days, respectively, postrandomization). Adherence to monitoring prior to each cisplatin dose was 83.3% for those randomized to A-OM compared with 4.5% for UC. Randomization to A-OM was not associated with reduced ototoxic hearing shifts or self-reported hearing handicap relative to UC; neither did it compromise participants' survival. Half of participants in each arm accessed aural rehabilitation services. One in each arm had a documented ototoxicity-related cisplatin dose reduction. Conclusions Auditory impairment was an actionable concern for the participants and their oncology providers. A dedicated surveillance program using the Oto-ID's automated protocols improved adherence to OM recommendations over a traditional UC service delivery model. Supplemental Material https://doi.org/10.23641/asha.16649602.
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Affiliation(s)
- Dawn Konrad-Martin
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology—Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Keri O'Connell Bennett
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - Angela Garinis
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology—Head & Neck Surgery, Oregon Health & Science University, Portland
- Oregon Hearing Research Center, Oregon Health & Science University, Portland
| | - Garnett P. McMillan
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology—Head & Neck Surgery, Oregon Health & Science University, Portland
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16
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Pitathawatchai P, Chaichulee S, Kirtsreesakul V. Robust machine learning method for imputing missing values in audiograms collected in children. Int J Audiol 2021; 61:66-77. [PMID: 33641573 DOI: 10.1080/14992027.2021.1884909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the accuracy and reliability of a machine learning (ML) algorithm for predicting the full audiograms of hearing-impaired children relative to the common approach (CA). DESIGN Retrospective study. STUDY SAMPLE There were 206 audiograms included from 206 children with sensorineural hearing loss. Nested cross-validation was used for evaluating the performance of the CA and ML. Six audiogram prediction simulations were performed in which either one or two thresholds across 0.5-4 kHz from complete audiograms in the dataset were labelled. Missing thresholds at the remaining frequencies were then predicted using the CA and ML in each simulation. The accuracy of the ML algorithm was determined by comparing the median average absolute threshold differences between the CA and ML using Wilcoxon signed-rank test. The reliability between runs of the ML was also assessed with Cronbach's alphas. RESULTS The median average absolute threshold differences in ML (5-8 dBHL) were statistically significantly lower than those in CA (6.25-10 dBHL) in all six simulations (p value < 0.05). The ML algorithm was also found to be reliable to predict the audiograms in all six simulations (α > 0.9). CONCLUSION Using the ML to predict the children's audiograms was reliable and more accurate than using the CA.
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Affiliation(s)
- Pittayapon Pitathawatchai
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Sitthichok Chaichulee
- Institute of Biomedical Engineering, Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Virat Kirtsreesakul
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
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17
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Wallhagen MI, Strawbridge WJ, Tremblay K. Leveraging the age friendly healthcare system initiative to achieve comprehensive, hearing healthcare across the spectrum of healthcare settings: an interprofessional perspective. Int J Audiol 2021; 60:80-85. [PMID: 33415999 DOI: 10.1080/14992027.2020.1853263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Hearing loss is associated with multiple physical, cognitive, and psychosocial co-morbidities. Achievement of safe healthcare in the context of these complex co-morbidities necessitates accurate hearing and coordination across specialties. This paper discusses the potentials for and barriers to an interprofessional approach to integrating hearing screening and treatment across all healthcare settings. DESIGN The paper reviews the relationship between hearing loss and other health care concerns to emphasise the need for an inclusive, coordinated, interprofessional approach; discusses interprofessional and patient/family centred coordinated care as essential to achieving quality care; and introduces the Age Friendly Health System initiative as a framework that could be leveraged to move towards comprehensive hearing healthcare. RESULTS The literature highlights prior work identifying gaps in quality care and the need for new and innovative approaches to evolve interdisciplinary and interprofessional collaborations to achieve comprehensive healthcare. The literature also provides support for using the Age-Friendly initiative as a point of leverage. CONCLUSION Bringing together thought leaders from the health care provider community, World Health Organisation, age-friendly cities movement, and field of architecture to coordinate the integration of hearing healthcare into Age Friendly Health Systems initiatives has potential to achieve comprehensive hearing healthcare across healthcare settings. (198).
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Affiliation(s)
- Margaret I Wallhagen
- Department of Physiological Nursing, University of California, San Francisco, CA, USA
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18
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Ototoxicity prevention during the SARS-CoV-2 (COVID-19) emergency. J Glob Antimicrob Resist 2020; 23:263-264. [PMID: 33075521 PMCID: PMC7568171 DOI: 10.1016/j.jgar.2020.09.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/10/2020] [Accepted: 09/29/2020] [Indexed: 11/20/2022] Open
Abstract
To remind the risk of ototoxicity when using chloroquine and hydroxychloroquine, in particular as prophylactic agents against SARS-CoV-2, during the pandemic. Otoacoustic Emissions (OAEs) are reported to be very sensitive in evaluating early manifestations of cochlear ototoxic damages. Healthy subjects taking chloroquine and hydroxychloroquine as prophylactic agent against SARS-CoV-2, during the pandemic, should be screened periodically, at least by OAEs.
Aim of this paper is to remind the risk of ototoxicity when using chloroquine and hydroxychloroquine, in particular as prophylactic agents against SARS-CoV-2, during the pandemic. Healthy subjects taking chloroquine and hydroxychloroquine as prophylactic agents against SARS-CoV-2, during the pandemic, should be screened periodically, at least by Otoacoustic Emissions (OAEs) in order to detect early manifestations of possible cochlear ototoxic damages.
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Abstract
Tinnitus is a common symptom for which there is in most cases no causal therapy. The search for an improvement of tinnitus through pharmacological interventions has a long tradition. The observation that tinnitus can be transiently suppressed by the use of lidocaine has shown that the symptom is susceptible to pharmacotherapy. So far, however, no medication has been found for either acute or chronic subjective tinnitus that reliably leads to a long-term reduction or even complete disappearance of the symptom for the majority of tinnitus sufferers. Nevertheless, in everyday clinical life, drugs are frequently used, usually off-label, to relieve tinnitus or tinnitus-associated symptoms (e.g. sleep disturbance, depression, anxiety disorder or hearing loss). This chapter shows the different approaches to acute and chronic subjective tinnitus by means of pharmacotherapeutic interventions. Furthermore, this review reports on the scientific studies carried out in this area in recent years and explains the difficulties in finding a suitable medication for most forms of tinnitus. In addition, it reports on the pharmacotherapeutic options for objective tinnitus and describes the development of tinnitus as a side effect of certain drugs. Finally, possible target structures are mentioned, which should possibly be addressed in pharmacological studies in the near future.
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Affiliation(s)
- Tobias Kleinjung
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany
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