Subscribe to RSS
DOI: 10.1055/s-0031-1277242
Detection of Ototoxicity
Publication History
Publication Date:
18 July 2011 (online)
![](https://www.thieme-connect.de/media/sih/201102/lookinside/thumbnails/10.1055-s-0031-1277242-1.jpg)
ABSTRACT
Ototoxicity monitoring is particularly critical in patients receiving platinum-based chemotherapy or long-term aminoglycoside antibiotic administration. Furthermore, as new otoprotective agents are developed, audiologists need to not only be able to monitor for ototoxicity but know the various criteria for early detection of ototoxicity and how to grade ototoxic adverse events. The three primary methods for ototoxicity monitoring are conventional audiometry, high-frequency audiometry, and otoacoustic emissions. However, early detection and adverse event criteria depend primarily on conventional and high-frequency audiometry. No consensus exists on determining significant changes in otoacoustic emissions secondary to ototoxic drugs. Also, no consensus exists on how to monitor for tinnitus, although it is a common complication in these patients. Currently, tinnitus surveys can be helpful. A baseline evaluation is critical for accurate interpretation of auditory threshold results. Thus, a team approach is needed to ensure adequate care of these children. For clinical trials and in reading the literature, audiologists need to be aware of the American Speech Language Hearing Association's 1994 criteria for detection of ototoxic change, and the Common Terminology Criteria for Adverse Events, Brock, and the Change scales for classification of adverse events. These methods and scales are reviewed and discussed.
KEYWORDS
Ototoxicity - pediatric - high-frequency audiometry - ototoxicity monitoring - early detection - adverse event - grading scales
REFERENCES
- 1 Fausti SA, Helt WJ, Gordon JS, Reavis KM, Phillips DS, Konrad-Martin DL. Audiologic monitoring for ototoxicity and patient management. In: Campbell K C, ed. Pharmacology and Ototoxicity for Audiologists. Clifton Park, NY: Thomson Delmar Learning; 2007: 230-248
- 2 Durrant J, Campbell K, Fausti S et al.. American Academy of Audiology Position Statement and Clinical Practice Guidelines. 2009: 1–25. Available at: http://www.audiology.org Accessed May 10, 2011;
- 3 Rybak LP, Huang X, Campbell K C. Cancer and Ototoxicity of Chemotherapeutics. In: Campbell K C, ed. Pharmacology and Ototoxicity for Audiologists. Clifton Park, NY: Thomson Delmar Learning; 2007
- 4 Rybak LP. Hearing: the effects of chemicals. Otolaryngol Head Neck Surg. 1992; 106 (6) 677-686
- 5 Lonsbury-Martiin B, Martin GK. Other ototoxins: aspirin, quinine and non-steroidal anti-inflammatory drugs and the macrolides. In: Campbell K C, ed. Pharmacology and Ototoxicity for Audiologists. Clifton Park, NY: Thomson Delmar Learning; 2007: 187-194
- 6 Campbell KCM, Durrant JD. Audiologic monitoring for ototoxicity. Otolaryngol Clin North Am. 1993; 26 (5) 903-914
- 7 Campbell KCM. Audiologic Monitoring for Ototoxicity. In: Roland P, Rutka J, eds. Ototoxicity. New York, NY: BC Decker; 2004: 53-60
- 8 Pouyatos B, Fechter L. Industrial chemicals and solvents affecting the auditory system. In: Campbell K C, ed. Pharmacology and Ototoxicity for Audiologists. Clifton Park, NY: Thomson Delmar Learning; 2007: 197-210
- 9 Meikle MB. Methods for evaluation of tinnitus relief procedures. In: Tinnitus 91. Proceedings of the Fourth International Tinnitus Seminar. Amsterdam, The Netherlands: Kugler; 1992
- 10 Meikle MB, Griest SE, Stewart BJ, Press LS. Measuring the negative impact of tinnitus: a brief severity index. Abstr Assoc Res Otolaryngol. 1995; 167
- 11 WHO .International Classification of Impairments, Disabilities, and Handicaps: A Manual of Classification Relating to the Consequences of Disease. Geneva, Switzerland: World Health Organization; 1980
- 12 Meikle MB, Griest SE. Tinnitus severity and disability: prospective efforts to develop a core set of measures. In: Proceedings of the Seventh International Tinnitus Seminar. Perth, Australia: University of Western Australia; 2002
- 13 Newman CW, Jacobson GP, Spitzer JB. Development of the Tinnitus Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1996; 122 (2) 143-148
- 14 Newman CW, Sandridge SA, Jacobson GP. Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome. J Am Acad Audiol. 1998; 9 (2) 153-160
- 15 Levine RA. Somatic modulation appears to be a fundamental attribute of tinnitus. In: Proceedings of the Sixth International Tinnitus Seminar. London, United Kingdom: Tinnitus and Hyperacusis Centre; 1999
- 16 Bauman N, Jastreboff PF. Real-ear measurement of the sound levels used by patients during TRT. In: Proceedings of the Sixth International Tinnitus Seminar. London, United Kingdom: Tinnitus and Hyperacusis Centre; 1999
- 17 Campbell KCM, Kelly E, Targovnik N et al.. Audiologic monitoring for potential ototoxicity in a phase I clinical trial of a new glycopeptide antibiotic. J Am Acad Audiol. 2003; 14 (3) 157-168 quiz 170-171
- 18 Carhart R, Jerer JF. Preferred method for clinical determination of pure-tone thresholds. J Speech Hear Res. 1959; 24 330-345
- 19 Osterhammel D. High frequency audiometry. Clinical aspects. Scand Audiol. 1980; 9 (4) 249-256
- 20 Kujansuu E, Rahko T, Punnonen R, Karma P. Evaluation of the hearing loss associated with cis-platinum treatment by high-frequency audiometry. Gynecol Oncol. 1989; 33 (3) 321-322
- 21 Stelmachowicz PG, Beauchaine KA, Kalberer A, Jesteadt W. Normative thresholds in the 8- to 20-kHz range as a function of age. J Acoust Soc Am. 1989; 86 (4) 1384-1391
- 22 Wiley TL, Cruickshanks KJ, Nondahl DM et al.. Aging and high-frequency hearing sensitivity. J Speech Lang Hear Res. 1998; 41 (5) 1061-1072
- 23 Kujansuu E, Rahko T, Punnonen R, Karma P. Evaluation of the hearing loss associated with cis-platinum treatment by high-frequency audiometry. Gynecol Oncol. 1989; 33 (3) 321-322
- 24 Stelmachowicz PG, Beauchaine KA, Kalberer A, Jesteadt W. Normative thresholds in the 8- to 20-kHz range as a function of age. J Acoust Soc Am. 1989; 86 (4) 1384-1391
- 25 Wiley TL, Cruickshanks KJ, Nondahl DM et al.. Aging and high-frequency hearing sensitivity. J Speech Lang Hear Res. 1998; 41 (5) 1061-1072
- 26 Northern JL, Ratkiewicz B. The quest for high-frequency normative data. Semin Hear. 1985; 6 (4) 331-339
- 27 Fausti SA, Frey RH, Rappaport BZ, Schechter MA. High frequency audiometry with an earphone transducer. Semin Hear. 1985; 6 (4) 347-357
- 28 Dreschler WA, vd Hulst RJ, Tange RA, Urbanus NA. The role of high-frequency audiometry in early detection of ototoxicity. Audiology. 1985; 24 (6) 387-395
- 29 Feghali JG, Bernstein RS. A new approach to serial monitoring of ultra-high frequency hearing. Laryngoscope. 1991; 101 (8) 825-829
- 30 Frank T, Dreisbach LE. Repeatability of high-frequency thresholds. Ear Hear. 1991; 12 (4) 294-295
- 31 Frank T. High-frequency hearing thresholds in young adults using a commercially available audiometer. Ear Hear. 1990; 11 (6) 450-454
- 32 Frank T. High-frequency (8 to 16 kHz) reference thresholds and intrasubject threshold variability relative to ototoxicity criteria using a Sennheiser HDA 200 earphone. Ear Hear. 2001; 22 (2) 161-168
- 33 Plinkert PK, Kröber S. Early detection of cisplatin-induced ototoxicity using evoked otoacoustic emissions. Laryngorhinootologie. 1991; 70 (9) 457-462
- 34 Beck A, Maurer J, Welkoborsky HJ, Mann W. Changes in transitory evoked otoacoustic emissions in chemotherapy with cisplatin and 5FU. HNO. 1992; 40 (4) 123-127
- 35 Zorowka PG, Schmitt HJ, Gutjahr P. Evoked otoacoustic emissions and pure tone threshold audiometry in patients receiving cisplatinum therapy. Int J Pediatr Otorhinolaryngol. 1993; 25 (1-3) 73-80
- 36 Stavroulaki P, Apostolopoulos N, Dinopoulou D, Vossinakis I, Tsakanikos M, Douniadakis D. Otoacoustic emissions—an approach for monitoring aminoglycoside induced ototoxicity in children. Int J Pediatr Otorhinolaryngol. 1999; 50 (3) 177-184
- 37 Mulheran M, Degg C. Comparison of distortion product OAE generation between a patient group requiring frequent gentamicin therapy and control subjects. Br J Audiol. 1997; 31 (1) 5-9
- 38 Ress BD, Sridhar KS, Balkany TJ, Waxman GM, Stagner BB, Lonsbury-Martin BL. Effects of cis-platinum chemotherapy on otoacoustic emissions: the development of an objective screening protocol. Third place—Resident Clinical Science Award 1998. Otolaryngol Head Neck Surg. 1999; 121 (6) 693-701
- 39 Lonsbury-Martin BL, Martin GK. Evoked otoacoustic emissions as objective screeners for ototoxicity. Semin Hear. 2001; 22 (4) 377-391
- 40 Knight KRG, Kraemer DF, Neuwelt EA. Ototoxicity in children receiving platinum chemotherapy: underestimating a commonly occurring toxicity that may influence academic and social development. J Clin Oncol. 2005; 23 (34) 8588-8596
- 41 Knight KR, Kraemer DF, Winter C, Neuwelt EA. Early changes in auditory function as a result of platinum chemotherapy: use of extended high-frequency audiometry and evoked distortion product otoacoustic emissions. J Clin Oncol. 2007; 25 (10) 1190-1195
- 42 Fausti SA, Henry JA, Helt WJ et al.. An individualized, sensitive frequency range for early detection of ototoxicity. Ear Hear. 1999; 20 (6) 497-505
- 43 Chang K W. Chinosornvatana N. Practical grading system for evaluating cisplatin ototoxicity in children. J Clin Oncol. 2010; 28 (10) 1788-1795
Kathleen C.M. CampbellPh.D.
Professor and Director of Audiology Research
Office #3341, 801 N. Rutledge, Southern Illinois University School of Medicine, Springfield, IL 62702
Email: kcampbell@siumed.edu