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The use of high‐frequency audiometry increases the diagnosis of asymptomatic hearing loss in pediatric patients treated with cisplatin‐based chemotherapy
Author(s) -
Abujamra Ana Lucia,
Escosteguy Juliana Ribas,
Dall'Igna Celso,
Manica Denise,
Cigana Luciana Facchini,
Coradini Patrícia,
Brunetto André,
Gregianin Lauro José
Publication year - 2013
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24236
Subject(s) - medicine , ototoxicity , audiology , audiometry , hearing loss , asymptomatic , pure tone audiometry , sensorineural hearing loss , cisplatin , chemotherapy , surgery
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. Pediatr Blood Cancer 2013; 60: 474–478. © 2012 Wiley Periodicals, Inc.