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Bader K, Dierkes L, Braun LH, Gummer AW, Dalhoff E, Zelle D. Test-retest reliability of distortion-product thresholds compared to behavioral auditory thresholds. Hear Res 2021; 406:108232. [PMID: 33984603 DOI: 10.1016/j.heares.2021.108232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
When referred to baseline measures, serial monitoring of pure-tone behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) can be used to detect the progression of cochlear damage. Semi-logarithmic DPOAE input-output (I/O) functions enable the computation of estimated distortion-product thresholds (EDPTs) by means of linear regression, a metric that provides a quantitative estimate of hearing loss due to cochlear-amplifier degradation. DPOAE wave interference and a suboptimal choice of stimulus levels limit the accuracy of EDPTs. This work identifies the test-retest reliability of EDPTs derived from short-pulse DPOAE level maps (EDPTLM), a method that circumvents limitations associated with both wave interference and suboptimal choice of stimulus levels. The test-retest reliability was compared to that of EDPTs derived from semi-logarithmic I/O functions (EDPTI/O) and that of behavioral thresholds acquired with pure-tone audiometry (PTA) and modified Békésy tracking audiometry (TA) to provide a foundation for identifying and interpreting significant threshold shifts. The DPOAE-based auditory thresholds (EDPTLM and EDPTI/O) and behavioral thresholds (PTA and TA) were recorded seven times within three months at 14 frequencies with f2 = 1-14 kHz in 20 ears from ten subjects with normal hearing (4PTA0.5-4kHz < 20 dB HL). To obtain EDPTLM, short-pulse DPOAEs were recorded using 21 L1,L2 pairs. Reconstruction of DPOAE growth behavior as a function of L1 and L2 using nonlinear curve fitting enabled the derivation of EDPTLM for each frequency. Test-retest reliability was determined using three different approaches: 1) centered thresholds, 2) average threshold differences, and 3) average absolute threshold differences, between each possible test session (N = 21). Test-retest reliability based on centered thresholds and average threshold differences showed no statistically significant difference between EDPTLM, EDPTI/O, PTA, and TA for the pooled analysis incorporating all stimulus frequencies. Average absolute threshold differences presented small but significant differences in test-retest reliability with median values of 3.00 dB for PTA, 3.20 dB for TA, 3.34 dB for EDPTLM, and 3.51 dB for EDPTI/O. A considerable frequency dependence of test-retest reliability was found; namely, the highest test-retest reliability was for EDPTLM at f2 = 11 - 14 kHz. Otherwise, at lower frequencies, the highest test-retest reliability was for TA at f2 =1 - 2 kHz. Overall, the test-retest reliability of EDPTLM was better than that of EDPTI/O and was similar to that for behavioral thresholds. Hence, deriving EDPTLM from individual level maps is a promising and sensitive method for objectively monitoring the state of the cochlea. Furthermore, the detection of an equidirectional threshold change at a single frequency in both EDPTLM and TA might allow reducing the threshold shift as indication of a follow-up examination from the clinical standard of 10 dB down to 5 dB. This stricter indicator might be beneficial when monitoring cochlear damage, for example ototoxicity, in the presence of (remnant) cochlear amplification at baseline.
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Affiliation(s)
- Katharina Bader
- Department of Otolaryngology, Head and Neck Surgery, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Linda Dierkes
- Department of Otolaryngology, Head and Neck Surgery, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Lore Helene Braun
- Department of Radiooncology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany; Current address: Department of Radiooncology, Marienhospital Stuttgart, Böheimstraße 37, 70199 Stuttgart, Germany
| | - Anthony W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany; Current address: Redwave Medical GmbH, Hans-Knöll-Str. 6, 07745 Jena, Germany
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Clemens E, van den Heuvel-Eibrink MM, Mulder RL, Kremer LCM, Hudson MM, Skinner R, Constine LS, Bass JK, Kuehni CE, Langer T, van Dalen EC, Bardi E, Bonne NX, Brock PR, Brooks B, Carleton B, Caron E, Chang KW, Johnston K, Knight K, Nathan PC, Orgel E, Prasad PK, Rottenberg J, Scheinemann K, de Vries ACH, Walwyn T, Weiss A, Am Zehnhoff-Dinnesen A, Cohn RJ, Landier W. Recommendations for ototoxicity surveillance for childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCare Consortium. Lancet Oncol 2019; 20:e29-e41. [PMID: 30614474 PMCID: PMC7549756 DOI: 10.1016/s1470-2045(18)30858-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 01/26/2023]
Abstract
Childhood, adolescent, and young adult (CAYA) cancer survivors treated with platinum-based drugs, head or brain radiotherapy, or both have an increased risk of ototoxicity (hearing loss, tinnitus, or both). To ensure optimal care and reduce consequent problems-such as speech and language, social-emotional development, and learning difficulties-for these CAYA cancer survivors, clinical practice guidelines for monitoring ototoxicity are essential. The implementation of surveillance across clinical settings is hindered by differences in definitions of hearing loss, recommendations for surveillance modalities, and remediation. To address these deficiencies, the International Guideline Harmonization Group organised an international multidisciplinary panel, including 32 experts from ten countries, to evaluate the quality of evidence for ototoxicity following platinum-based chemotherapy and head or brain radiotherapy, and formulate and harmonise ototoxicity surveillance recommendations for CAYA cancer survivors.
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Affiliation(s)
- Eva Clemens
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Hematology and Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | | | - Renée L Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Melissa M Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Roderick Skinner
- Department of Pediatric and Adolescent Hematology/Oncology and Children's Hematopoietic Stem Cell Transplant Unit, Great North Children's Hospital and Institute of Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Louis S Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, New York, NY, USA
| | - Johnnie K Bass
- Rehabilitation Services, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Claudia E Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Pediatrics, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Thorsten Langer
- Pediatric Oncology and Hematology, University Hospital for Children and Adolescents, Lübeck, Germany
| | - Elvira C van Dalen
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Edith Bardi
- Department of Pediatrics and Adolescent Medicine, Kepler Universitätsklinikum, Linz, Austria
| | | | - Penelope R Brock
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Beth Brooks
- Rehabilitation Services, St Jude Children's Research Hospital, Memphis, TN, USA; Audiology and Speech Pathology Department, British Columbia's Children's Hospital, Vancouver, BC, Canada; School of Audiology and Speech Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Bruce Carleton
- Pharmaceutical Outcomes Programme, British Columbia's Children's Hospital, Vancouver, BC, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric Caron
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Kay W Chang
- Department of Otolaryngology, Stanford University, Palo Alto, CA, USA
| | - Karen Johnston
- Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, NSW, Australia
| | - Kristin Knight
- Department of Pediatric Audiology, Child Development and Rehabilitation Center, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, OR, USA
| | - Paul C Nathan
- Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Etan Orgel
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Pinki K Prasad
- Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, USA; Division of Pediatric Hematology/Oncology, Children's Hospital of New Orleans, New Orleans, LA, USA
| | - Jan Rottenberg
- Department of Otolaryngology and Head and Neck Surgery, St Ann's University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Katrin Scheinemann
- Division of Pediatric Hematology/Oncology, Hospital for Children and Adolescents, Cantonal Hospital Aarau, Aarau, Switzerland; Division of Pediatric Hematology/Oncology, University for Children's Hospital Basel, Basel, Switzerland; Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, McMaster University, Hamilton, ON, Canada
| | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Hematology and Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Thomas Walwyn
- Department of Pediatric and Adolescent Oncology, Perth Children's Hospital, Nedlands, WA, Australia; School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Annette Weiss
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Antoinette Am Zehnhoff-Dinnesen
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, Westphalian Wilhelm University of Münster, Münster, Germany
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales Medicine, Sydney, NSW, Australia
| | - Wendy Landier
- Institute for Cancer Outcomes and Survivorship, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, AL, USA.
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Hoth S, Baljić I. Current audiological diagnostics. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2017; 16:Doc09. [PMID: 29279727 PMCID: PMC5738938 DOI: 10.3205/cto000148] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Today's audiological functional diagnostics is based on a variety of hearing tests, whose large number takes account of the variety of malfunctions of a complex sensory organ system and the necessity to examine it in a differentiated manner and at any age of life. The objective is to identify nature and origin of the hearing loss and to quantify its extent as far as necessary to dispose of the information needed to initiate the adequate medical (conservative or operational) treatment or the provision with technical hearing aids or prostheses. Moreover, audiometry provides the basis for the assessment of impairment and handicap as well as for the calculation of the degree of disability. In the present overview, the current state of the method inventory available for practical use is described, starting from basic diagnostics over to complex special techniques. The presentation is systematically grouped in subjective procedures, based on psychoacoustic exploration, and objective methods, based on physical measurements: preliminary hearing tests, pure tone threshold, suprathreshold processing of sound intensity, directional hearing, speech understanding in quiet and in noise, dichotic hearing, tympanogram, acoustic reflex, otoacoustic emissions and auditory evoked potentials. Apart from a few still existing gaps, this method inventory covers the whole spectrum of all clinically relevant functional deficits of the auditory system.
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Affiliation(s)
- Sebastian Hoth
- Functional Area of Audiology, Department of Otolaryngology, University of Heidelberg, Germany
| | - Izet Baljić
- Department of Otolaryngology, HELIOS Hospital of Erfurt, Germany
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Brooks B, Knight K. Ototoxicity monitoring in children treated with platinum chemotherapy. Int J Audiol 2017; 57:S34-S40. [DOI: 10.1080/14992027.2017.1355570] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Beth Brooks
- Registered Audiologist, British Columbia's Children's Hospital, Vancouver, BC, Canada and
| | - Kristin Knight
- Department of Pediatric Audiology, Child Development and Rehabilitation Center, Doernbecher Children’s Hospital, Oregon Health and Science University, Portland, OR, USA
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Fetoni AR, Ruggiero A, Lucidi D, De Corso E, Sergi B, Conti G, Paludetti G. Audiological Monitoring in Children Treated with Platinum Chemotherapy. Audiol Neurootol 2016; 21:203-211. [PMID: 27286730 DOI: 10.1159/000442435] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 09/24/2015] [Indexed: 11/19/2022] Open
Abstract
Platinum compounds constitute the standard treatment for solid tumors in pediatric oncology. The purpose of this study is to assess the impact of platinum compounds in the development of ototoxicity in children following chemotherapy. This study included 160 patients treated with cisplatin and carboplatin for malignant solid diseases from 2007 to 2014. Their audiograms were classified according to the Boston SIOP ototoxicity scale. Twenty-five percent of the children treated with platinum compounds developed ototoxicity. The incidence of ototoxicity was correlated with the type of platinum derivative (i.e. cisplatin vs. carboplatin), coadministration of both drugs and concomitant cranial radiotherapy, but not with sex and age. Cumulative dose was correlated only with the cisplatin administration. Nine patients (8.6%) showed further progression of hearing impairment after the end of chemotherapy. The low rate of ototoxicity suggests the pivotal role of auditory monitoring in children treated with platinum compounds in order to be able to identify hearing loss at an early stage and to provide, jointly with pediatric oncologists, strategies to reduce further progression of cochlear toxicity.
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Affiliation(s)
- A R Fetoni
- Department of Otolaryngology, Head and Neck Surgery, A. Gemelli Hospital, Università Cattolica, Rome, Italy
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Abstract
OBJECTIVE Drug-mediated ototoxicity, specifically cochleotoxicity, is a concern for patients receiving medications for the treatment of serious illness. A number of classification schemes exist, most of which are based on pure-tone audiometry, in order to assist non-audiological/non-otological specialists in the identification and monitoring of iatrogenic hearing loss. This review identifies the primary classification systems used in cochleototoxicity monitoring. By bringing together classifications published in discipline-specific literature, the paper aims to increase awareness of their relative strengths and limitations in the assessment and monitoring of ototoxic hearing loss and to indicate how future classification systems may improve upon the status-quo. DESIGN Literature review. STUDY SAMPLE PubMed identified 4878 articles containing the search term ototox*. RESULTS A systematic search identified 13 key classification systems. Cochleotoxicity classification systems can be divided into those which focus on hearing change from a baseline audiogram and those that focus on the functional impact of the hearing loss. CONCLUSIONS Common weaknesses of these grading scales included a lack of sensitivity to small adverse changes in hearing thresholds, a lack of high-frequency audiometry (>8 kHz), and lack of indication of which changes are likely to be clinically significant for communication and quality of life.
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Affiliation(s)
- Gemma Crundwell
- a Audiology Department, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK
| | - Phil Gomersall
- a Audiology Department, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK.,b Vision and Hearing Sciences Department, Anglia Ruskin University , Cambridge , UK
| | - David M Baguley
- a Audiology Department, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK.,b Vision and Hearing Sciences Department, Anglia Ruskin University , Cambridge , UK
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Yu KK, Choi CH, An YH, Kwak MY, Gong SJ, Yoon SW, Shim HJ. Comparison of the effectiveness of monitoring Cisplatin-induced ototoxicity with extended high-frequency pure-tone audiometry or distortion-product otoacoustic emission. KOREAN JOURNAL OF AUDIOLOGY 2014; 18:58-68. [PMID: 25279227 PMCID: PMC4181054 DOI: 10.7874/kja.2014.18.2.58] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/01/2014] [Accepted: 07/10/2014] [Indexed: 12/05/2022]
Abstract
Background and Objectives To compare the effectiveness of monitoring cisplatin-induced ototoxicity in adult patients using extended high-frequency pure-tone audiometry (EHF-PTA) or distortion-product otoacoustic emission (DP-OAE) and to evaluate the concurrence of ototoxicity and nephrotoxicity in cisplatin-treated patients. Subjects and Methods EHF-PTA was measured at frequencies of 0.25, 0.5, 1, 2, 3, 4, 6, 8, 9, 11.2, 12.5, 14, 16, 18, and 20 kHz and DP-OAE at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz in cisplatin-treated patients (n=10). Baseline evaluations were made immediately before chemotherapy and additional tests were performed before each of six cycles of cisplatin treatment. Laboratory tests to monitor nephrotoxicity were included before every cycle of chemotherapy. Results Four of 10 patients showed threshold changes on EHF-PTA. Five of 10 patients showed reductions in DP-OAE, but one was a false-positive result. The results of EHF-PTA and DP-OAE were consistent in two patients. Only one patient displayed nephrotoxicity on laboratory tests after the third cycle. Conclusions In our study, the incidence rate of cisplatin-induced ototoxicity was 40% with EHF-PTA or DP-OAE. Although both EHF-PTA and DP-OAE showed the same sensitivity in detecting ototoxicity, they did not produce the same results in all patients. These two hearing tests could be used to complement one another. Clinicians should use both tests simultaneously in every cycle of chemotherapy to ensure the detection of ototoxicity.
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Affiliation(s)
- Kwang Kyu Yu
- Department of Otolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Chi Ho Choi
- Department of Otolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Yong-Hwi An
- Department of Otolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Min Young Kwak
- Department of Otolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Soo Jung Gong
- Department of Internal Medicine, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Sang Won Yoon
- Department of Otolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Hyun Joon Shim
- Department of Otolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
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Theunissen EAR, Bosma SCJ, Zuur CL, Spijker R, van der Baan S, Dreschler WA, de Boer JP, Balm AJM, Rasch CRN. Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: A systematic review of the literature. Head Neck 2014; 37:281-92. [DOI: 10.1002/hed.23551] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2013] [Indexed: 11/06/2022] Open
Affiliation(s)
- Eleonoor A. R. Theunissen
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Sophie C. J. Bosma
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Charlotte L. Zuur
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam The Netherlands
- Department of Maxillofacial Surgery; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
| | - René Spijker
- Medical Library, Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
- Dutch Cochrane Center; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
| | - Sieberen van der Baan
- Department of Otorhinolaryngology; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
| | - Wouter A. Dreschler
- Department of Otorhinolaryngology-Audiology; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
| | - Jan Paul de Boer
- Department of Medical Oncology; The Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Alfons J. M. Balm
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam The Netherlands
- Department of Maxillofacial Surgery; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
| | - Coen R. N. Rasch
- Department of Radiation Oncology; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
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Seddon JA, Thee S, Jacobs K, Ebrahim A, Hesseling AC, Schaaf HS. Hearing loss in children treated for multidrug-resistant tuberculosis. J Infect 2013; 66:320-9. [DOI: 10.1016/j.jinf.2012.09.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 08/31/2012] [Accepted: 09/02/2012] [Indexed: 11/25/2022]
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Abujamra AL, Escosteguy JR, Dall'Igna C, Manica D, Cigana LF, Coradini P, Brunetto A, Gregianin LJ. The use of high-frequency audiometry increases the diagnosis of asymptomatic hearing loss in pediatric patients treated with cisplatin-based chemotherapy. Pediatr Blood Cancer 2013; 60:474-8. [PMID: 22744939 DOI: 10.1002/pbc.24236] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 05/23/2012] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cisplatin may cause permanent cochlear damage by changing cochlear frequency selectivity and can lead to irreversible sensorineural hearing loss. High-frequency audiometry (HFA) is able to assess hearing frequencies above 8,000 Hz; hence, it has been considered a high-quality method to monitor and diagnose early and asymptomatic signs of ototoxicity in patients receiving cisplatin. PROCEDURE Forty-two pediatric patients were evaluated for hearing loss induced by cisplatin utilizing HFA, and its diagnostic efficacy was compared to that of standard pure-tone audiometry and distortion-product otoacoustic emissions (DPOAEs). The patient population consisted of those who signed an informed consent form and had received cisplatin chemotherapy between 1991 and 2008 at the Hospital de Clínicas de Porto Alegre Pediatric Unit, Brazil. RESULTS Forty-two patients were evaluated. The median age at study assessment was 14.5 years (range 4-37 years). Hearing loss was detected in 24 patients (57%) at conventional frequencies. Alterations of DPOAEs were found in 64% of evaluated patients and hearing loss was observed in 36 patients (86%) when high-frequency test was added. The mean cisplatin dose was significantly higher (P = 0.046) for patients with hearing impairment at conventional frequencies. CONCLUSION The results suggest that HFA is more effective than pure-tone audiometry and DPOAEs in detecting hearing loss, particularly at higher frequencies. It may be a useful tool for testing new otoprotective agents, beside serving as an early diagnostic method for detecting hearing impairment.
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Danesh AA, Kaf WA. DPOAEs and contralateral acoustic stimulation and their link to sound hypersensitivity in children with autism. Int J Audiol 2012; 51:345-52. [DOI: 10.3109/14992027.2011.626202] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dionne F, Mitton C, Rassekh R, Brooks B, Ross C, Hayden M, Carleton B. Economic impact of a genetic test for cisplatin-induced ototoxicity. THE PHARMACOGENOMICS JOURNAL 2011; 12:205-13. [DOI: 10.1038/tpj.2011.15] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Bhagat SP, Bass JK, White ST, Qaddoumi I, Wilson MW, Wu J, Rodriguez-Galindo C. Monitoring carboplatin ototoxicity with distortion-product otoacoustic emissions in children with retinoblastoma. Int J Pediatr Otorhinolaryngol 2010; 74:1156-63. [PMID: 20667604 PMCID: PMC4787621 DOI: 10.1016/j.ijporl.2010.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Revised: 06/30/2010] [Accepted: 07/02/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Carboplatin is a common chemotherapy agent with potential ototoxic side effects that is used to treat a variety of pediatric cancers, including retinoblastoma. Retinoblastoma is a malignant tumor of the retina that is usually diagnosed in young children. Distortion-product otoacoustic emission tests offer an effective method of monitoring for ototoxicity in young children. This study was designed to compare measurements of distortion-product otoacoustic emissions obtained before and after several courses of carboplatin chemotherapy in order to examine if (a) mean distortion-product otoacoustic emission levels were significantly different; and (b) if criterion reductions in distortion-product otoacoustic emission levels were observed in individual children. METHODS A prospective repeated measures study. Ten children with a median age of 7.6 months (range, 3-72 months) diagnosed with unilateral or bilateral retinoblastoma were examined. Distortion-product otoacoustic emissions were acquired from both ears of the children with 65/55 dB SPL primary tones (f(2)=793-7996 Hz) and a frequency resolution of 3 points/octave. Distortion-product otoacoustic emission levels in dB SPL were measured before chemotherapy treatment (baseline measurement) and after 3-4 courses of chemotherapy (interim measurement). Comparisons were made between baseline and interim distortion-product otoacoustic emission levels (collapsed across ears). Evidence of ototoxicity was based on criterion reductions (≥ 6 dB) in distortion-product otoacoustic emission levels. RESULTS Significant differences between baseline and interim mean distortion-product otoacoustic emission levels were only observed at f(2) = 7996 Hz. Four children exhibited criterion reductions in distortion-product otoacoustic emission levels. CONCLUSIONS Mean distortion-product otoacoustic emission levels at most frequencies were not changed following 3-4 courses of carboplatin chemotherapy in children with retinoblastoma. However, on an individual basis, children receiving higher doses of carboplatin exhibited criterion reductions in distortion-product otoacoustic emission level at several frequencies. These findings suggest that higher doses of carboplatin affect outer hair cell function, and distortion-product otoacoustic emission tests can provide useful information when monitoring children at risk of developing carboplatin ototoxicity.
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Affiliation(s)
- Shaum P Bhagat
- School of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, United States.
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Burke SR, Rogers AR, Neely ST, Kopun JG, Tan H, Gorga MP. Influence of calibration method on distortion-product otoacoustic emission measurements: I. test performance. Ear Hear 2010; 31:533-45. [PMID: 20458246 PMCID: PMC2896442 DOI: 10.1097/aud.0b013e3181d86b3d] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Calibration errors in distortion-product otoacoustic emission (DPOAE) measurements because of standing waves cause unpredictable changes in stimulus and DPOAE response level. The purpose of this study was to assess the extent to which these errors affect DPOAE test performance. Standard calibration procedures use sound pressure level (SPL) to determine specified levels. Forward pressure level (FPL) is an alternate calibration method that is less susceptible to standing waves. However, FPL derivation requires prior cavity measurements, which have associated variability. In an attempt to address this variability, four FPL methods were compared with SPL: a reference calibration derived from 25 measurements before all data collection and a daily calibration measurement, both of which were made at body and room temperature. DESIGN Data were collected from 52 normal-hearing and 103 hearing-impaired subjects. DPOAEs were measured for f2 frequencies ranging from 2 to 8 kHz in half-octave steps, with L2 ranging from -20 to 70 dB SPL (5-dB steps). At each f2, DPOAEs were measured in five calibration conditions: SPL, daily FPL at body temperature (daily body), daily FPL at room temperature (daily room), reference FPL at body temperature (ref body), and reference FPL at room temperature (ref room). Data were used to construct receiver operating characteristic (ROC) curves for each f2, calibration method, and L2. From these curves, areas under the ROC curve (AROC) were estimated. RESULTS The results of this study are summarized by the following observations: (1) DPOAE test performance was sensitive to stimulus level, regardless of calibration method, with the best test performance observed for moderate stimulus level conditions. (2) An effect of frequency was observed for all calibration methods, with the best test performance at 6 kHz and the worst performance at 8 kHz. (3) At clinically applicable stimulus levels, little difference in test performance among calibration methods was noted across frequencies, except at 8 kHz. At 8 kHz, FPL-based calibration methods provided superior performance compared with the standard SPL calibration. (4) A difference between FPL calibration methods was observed at 8 kHz, with the best test performance occurring for daily calibrations at body temperature. CONCLUSIONS With the exception of 8 kHz, there was little difference in test performance across calibration methods. At 8 kHz, AROCs and specificities for fixed sensitivities indicate that FPL-based calibration methods provide superior performance compared with the standard SPL calibration for clinically relevant levels. Temperature may have an impact on FPL calculations relative to DPOAE test performance. Although the differences in AROC among calibration procedures were not statistically significant, the present results indicate that standing wave errors may impact DPOAE test performance and can be reduced by using FPL, although the largest effects were restricted to 8 kHz.
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Affiliation(s)
- Sienna R. Burke
- University of Maryland, College Park, MD
- Boys Town National Research Hospital, Omaha, NE
| | - Abigail R. Rogers
- Indiana University, Bloomington, IN
- Boys Town National Research Hospital, Omaha, NE
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Schultz C, Goffi-Gomez MVS, Liberman PHP, Carvalho AL. Report on hearing loss in oncology. Braz J Otorhinolaryngol 2010; 75:634-41. [PMID: 19893928 PMCID: PMC9442188 DOI: 10.1016/s1808-8694(15)30510-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Accepted: 11/02/2008] [Indexed: 11/29/2022] Open
Abstract
Cisplatin is used frequently as an antineoplastic drug in the treatment of many different cancers. However, when used in doses over 360mg/m2, ototoxicity may ensue, resulting in loss of hearing. Criteria for identifying and quantifying hearing loss have been devised. Aim To describe the features of different hearing loss classification systems and to identify their implications and use in oncologic patients. Method Hearing loss was classified in 31 patients before and after chemotherapy, according to different criteria, assessing the sensitivity and specificity of each classification system. Results Hearing loss results were highly variable (ranging from 29% to 61%). Only 4 of 31 subjects with post-therapy hearing loss were identified by all the methods. A few subjects with hearing loss were classified as normal hearing in some of the criteria. A normal PTA was found in 18 of 31 subjects in the post-treatment evaluation. Conclusion None of the criteria assesses the complaints of patients. The criteria described in this study were inadequate to identify hearing loss following chemotherapy, requiring additional information for physicians to better understand the hearing losses and their implications for the quality of life of patients.
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Hoth S, Gudmundsdottir K, Plinkert P. Age dependence of otoacoustic emissions: the loss of amplitude is primarily caused by age-related hearing loss and not by aging alone. Eur Arch Otorhinolaryngol 2009; 267:679-90. [DOI: 10.1007/s00405-009-1106-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2008] [Accepted: 09/11/2009] [Indexed: 10/20/2022]
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Chiu LL, Cunningham LL, Raible DW, Rubel EW, Ou HC. Using the zebrafish lateral line to screen for ototoxicity. J Assoc Res Otolaryngol 2008; 9:178-90. [PMID: 18408970 DOI: 10.1007/s10162-008-0118-y] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Accepted: 03/05/2008] [Indexed: 10/22/2022] Open
Abstract
The zebrafish is a valuable model for studying hair cell development, structure, genetics, and behavior. Zebrafish and other aquatic vertebrates have hair cells on their body surface organized into a sensory system called the lateral line. These hair cells are highly accessible and easily visualized using fluorescent dyes. Morphological and functional similarities to mammalian hair cells of the inner ear make the zebrafish a powerful preparation for studying hair cell toxicity. The ototoxic potential of drugs has historically been uncovered by anecdotal reports that have led to more formal investigation. Currently, no standard screen for ototoxicity exists in drug development. Thus, for the vast majority of Food and Drug Association (FDA)-approved drugs, the ototoxic potential remains unknown. In this study, we used 5-day-old zebrafish larvae to screen a library of 1,040 FDA-approved drugs and bioactives (NINDS Custom Collection II) for ototoxic effects in hair cells of the lateral line. Hair cell nuclei were selectively labeled using a fluorescent vital dye. For the initial screen, fish were exposed to drugs from the library at a 100-muM concentration for 1 h in 96-well tissue culture plates. Hair cell viability was assessed in vivo using fluorescence microscopy. One thousand forty drugs were rapidly screened for ototoxic effects. Seven known ototoxic drugs included in the library, including neomycin and cisplatin, were positively identified using these methods, as proof of concept. Fourteen compounds without previously known ototoxicity were discovered to be selectively toxic to hair cells. Dose-response curves for all 21 ototoxic compounds were determined by quantifying hair cell survival as a function of drug concentration. Dose-response relationships in the mammalian inner ear for two of the compounds without known ototoxicity, pentamidine isethionate and propantheline bromide, were then examined using in vitro preparations of the adult mouse utricle. Significant dose-dependent hair cell loss in the mouse utricle was demonstrated for both compounds. This study represents an important step in validating the use of the zebrafish lateral line as a screening tool for the identification of potentially ototoxic drugs.
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Affiliation(s)
- Lynn L Chiu
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Box 356515, Seattle, WA 98195, USA
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