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Krishnan PS, Lauer AM, Ward BK, Seal SM, Nieman CL, Andresen NS. Sex and Race Representation in Temporal Bone Histopathology Studies in the United States: A Systematic Review. Ear Hear 2023; 44:661-669. [PMID: 36763469 PMCID: PMC10331314 DOI: 10.1097/aud.0000000000001340] [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] [Indexed: 02/11/2023]
Abstract
OBJECTIVES The author's objective was to evaluate sex and race representation in temporal bone histopathology studies. DESIGN PubMed, Embase, Cochrane, Web of Science, and Scopus were searched for studies written in English examining temporal bone histopathology specimens from U.S.-based institutions from January 1, 1947, to September 1, 2021. Two authors then performed "snowballing" by reviewing references from the initial search and included the studies that fulfilled the inclusion criteria. For each study, the following information was collected: publication details, study design, funding, institution from where temporal bone specimens were procured, number of study specimens, and donor demographical information. RESULTS The authors found that out of 300 studies, 166 (55%) report sex while only 15 (5%) reported race information. Over the past 70 years, the ratio of studies reporting sex to those that do not has increased from 1.00 to 2.19 and the number of female temporal bone histopathology subjects relative to male has increased from 0.67 to 0.75. Over 90% of studies that do report this information feature participant racial compositions that do not reflect the diversity of the U.S. population. CONCLUSIONS Studies of temporal bone histopathology often do not report participant sex or race. The reporting of participant sex and the inclusion of specimens from female donors have both increased over time. However, temporal bone histopathology study cohorts are not representative of the racial diversity of the U.S. population. The otolaryngology community must strive to build temporal bone histopathology libraries that are representative of the diverse U.S. population.
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Affiliation(s)
- Pavan S. Krishnan
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Amanda M. Lauer
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bryan K. Ward
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Stella M. Seal
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Carrie L. Nieman
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Cochlear Center for Hearing & Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
- Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Nicholas S. Andresen
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Westman MR, Putterman DB, Garinis AC, Hunter LL, Feeney MP. Wideband Acoustic Reflex Growth in Adults With Cystic Fibrosis. Am J Audiol 2021; 30:825-833. [PMID: 33661027 PMCID: PMC9126118 DOI: 10.1044/2020_aja-20-00117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/25/2020] [Accepted: 11/05/2020] [Indexed: 11/09/2022] Open
Abstract
Purpose Individuals with cystic fibrosis (CF) are often treated with intravenous (IV) aminoglycoside (AG) antibiotics to manage life-threatening bacterial infections. Preclinical animal data suggest that, in addition to damaging cochlear hair cells, this class of antibiotics may cause cochlear synaptopathy and/or damage to higher auditory structures. The acoustic reflex growth function (ARGF) is a noninvasive, objective measure of neural function in the auditory system. A shallow ARGF (small reflex-induced changes in middle ear function with increasing elicitor level) has been associated with synaptopathy due to noise exposure in rodent and human studies. In this study, the ARGF was obtained in CF patients with normal hearing, some of whom have been treated with IV AGs, and a control group without CF. The hypothesis was that patients with IV-AG exposure would have a shallow ARGF due to cochlear synaptopathy caused by ototoxicity. Method Wideband ARGFs were examined in four groups of normal-hearing participants: a control group of 29 individuals without CF; and in 57 individuals with CF grouped by lifetime IV-AG exposure: 15 participants with no exposure, 21 with low exposure, and 21 with high exposure. Procedures included pure-tone audiometry, clinical immittance, wideband acoustic immittance battery, including ARGFs, and transient evoked otoacoustic emissions. Results CF subjects with normal pure-tone thresholds and either high or low lifetime IV-AG exposure had enhanced ARGFs compared to controls and CF participants without IV-AG exposure. The groups did not differ in transient evoked otoacoustic emission signal-to-noise ratio. Conclusion These results diverge from the shallow ARGF pattern observed in studies of noise-induced cochlear synaptopathy and are suggestive of a central mechanism of auditory dysfunction in patients with AG-induced ototoxicity.
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Affiliation(s)
- Martha R. Westman
- National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis
| | - Daniel B. Putterman
- National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Angela C. Garinis
- National Center for Rehabilitative Auditory Research (NCRAR), 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
| | | | - M. Patrick Feeney
- National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
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Blankenship CM, Hunter LL, Feeney MP, Cox M, Bittinger L, Garinis AC, Lin L, McPhail G, Clancy JP. Functional Impacts of Aminoglycoside Treatment on Speech Perception and Extended High-Frequency Hearing Loss in a Pediatric Cystic Fibrosis Cohort. Am J Audiol 2021; 30:834-853. [PMID: 33465313 DOI: 10.1044/2020_aja-20-00059] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose The purpose of this study is to better understand the prevalence of ototoxicity-related hearing loss and its functional impact on communication in a pediatric and young adult cohort with cystic fibrosis (CF) and individuals without CF (controls). Method We did an observational, cross-sectional investigation of hearing function in children, teens, and young adults with CF (n = 57, M = 15.0 years) who received intravenous aminoglycoside antibiotics and age- and gender-matched controls (n = 61, M = 14.6 years). Participants completed standard and extended high-frequency audiometry, middle ear measures, speech perception tests, and a hearing and balance questionnaire. Results Individuals with CF were 3-4 times more likely to report issues with hearing, balance, and tinnitus and performed significantly poorer on speech perception tasks compared to controls. A higher prevalence of hearing loss was observed in individuals with CF (57%) compared to controls (37%). CF and control groups had similar proportions of slight and mild hearing losses; however, individuals with CF were 7.6 times more likely to have moderate and greater degrees of hearing loss. Older participants displayed higher average extended high-frequency thresholds, with no effect of age on average standard frequency thresholds. Although middle ear dysfunction has not previously been reported to be more prevalent in CF, this study showed that 16% had conductive or mixed hearing loss and higher rates of previous otitis media and pressure equalization tube surgeries compared to controls. Conclusions Individuals with CF have a higher prevalence of conductive, mixed, and sensorineural hearing loss; poorer speech-in-noise performance; and higher rates of multiple symptoms associated with otologic disorders (tinnitus, hearing difficulty, dizziness, imbalance, and otitis media) compared to controls. Accordingly, children with CF should be asked about these symptoms and receive baseline hearing assessment(s) prior to treatment with potentially ototoxic medications and at regular intervals thereafter in order to provide otologic and audiologic treatment for hearing- and ear-related problems to improve communication functioning.
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Affiliation(s)
- Chelsea M. Blankenship
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, OH
- Departments of Otolaryngology and Communication Sciences and Disorders, University of Cincinnati, OH
| | - Lisa L. Hunter
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, OH
- Departments of Otolaryngology and Communication Sciences and Disorders, University of Cincinnati, OH
| | - M. Patrick Feeney
- Oregon Hearing Research Center, Oregon Health & Science University, Portland
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - Madison Cox
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, OH
| | - Lindsey Bittinger
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, OH
| | - Angela C. Garinis
- Oregon Hearing Research Center, Oregon Health & Science University, Portland
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - Li Lin
- Research in Patient Services, Cincinnati Children's Hospital Medical Center, OH
| | - Gary McPhail
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - John P. Clancy
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, OH
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Vonk SEM, Weersink EJM, Majoor CJ, Kemper EM. Tobramycin and vestibulotoxicity: retrospective analysis of four cases. Eur J Hosp Pharm 2021; 29:e88-e90. [PMID: 33753422 PMCID: PMC8899640 DOI: 10.1136/ejhpharm-2020-002588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/23/2021] [Accepted: 03/09/2021] [Indexed: 11/05/2022] Open
Abstract
Over a course of 7 months, four patients developed vestibulotoxicity after treatment with intravenous tobramycin. Since vestibulotoxicity is a serious adverse effect which can be irreversible, an investigation was undertaken to determine if there was a cause for the toxicity and whether the quality of care had been inadequate. In this period, 26 patients with cystic fibrosis were treated with tobramycin according to valid guidelines, of which four experienced acute dizziness which disrupted their daily activities. Two patients experienced irreversible bilateral vestibular hypofunction and two unilateral loss of the right labyrinth, with decreasing dizziness over time. No apparent cause for the vestibulotoxicity was found in these four patients and the simultaneous occurrence was not due to a lack in quality of care. Symptoms of dizziness and balance disorders should be recognised by patients and caretakers at an early stage so additional diagnostics can be done to prevent further deterioration.
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Affiliation(s)
- S E M Vonk
- Hospital Pharmacy, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - E J M Weersink
- Respiratory Medicine, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - C J Majoor
- Respiratory Medicine, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - E M Kemper
- Hospital Pharmacy, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
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Longenecker RJ, Gu R, Homan J, Kil J. A Novel Mouse Model of Aminoglycoside-Induced Hyperacusis and Tinnitus. Front Neurosci 2020; 14:561185. [PMID: 33041759 PMCID: PMC7530258 DOI: 10.3389/fnins.2020.561185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/20/2020] [Indexed: 11/13/2022] Open
Abstract
Aminoglycosides (AG) such as amikacin are commonly used in cystic fibrosis patients with opportunistic pulmonary infections including multi-drug resistant mycobacterium tuberculous and non-tuberculous mycobacterium. Unfortunately, this class of drugs is known to cause peripheral damage to the cochlea leading to hearing loss that can fluctuate and become permanent over time or multiple exposures. However, whether amikacin can lead to central auditory dysfunction like hyperacusis (increased sensitivity to sound) or tinnitus (perception of sound in the absence of acoustic stimulation) is not well-described in the literature. Thus, an animal model needs to be developed that documents these side effects in order to develop therapeutic solutions to reduce AG-induced auditory dysfunction. Here we present pioneer work in mice which demonstrates that amikacin can lead to fluctuating behavioral evidence of hyperacusis and tinnitus as assessed by the acoustic startle reflex. Additionally, electrophysiological assessments of hearing via auditory brainstem response demonstrate increased central activity in the auditory brainstem. These data together suggest that peripheral AG-induced dysfunction can lead to central hyperactivity and possible behavioral manifestations of hyperacusis and tinnitus. Importantly, we demonstrate that ebselen, a novel investigational drug that acts as both an antioxidant and anti-inflammatory, can mitigate AG-induced hyperacusis.
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Affiliation(s)
| | - Rende Gu
- Sound Pharmaceuticals, Inc., Seattle, WA, United States
| | | | - Jonathan Kil
- Sound Pharmaceuticals, Inc., Seattle, WA, United States
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