The use of high-frequency audiometry increases the diagnosis of asymptomatic hearing loss in pediatric patients treated with cisplatin-based chemotherapy
The use of high-frequency audiometry increases the diagnosis of asymptomatic hearing loss in pediatric patients treated with cisplatin-based chemotherapy
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DOI：
10.1002/pbc.24236
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发表时间：
2013-03-01
影响因子：
3.2
通讯作者：
Gregianin, Lauro Jose
中科院分区：
文献类型：
--
作者：
Abujamra, Ana Lucia;Escosteguy, Juliana Ribas;Gregianin, Lauro Jose
背景顺铂可通过改变耳蜗频率选择性而导致永久性耳蜗损伤，并可导致不可逆的感音神经性听力损失。高频测听（HFA）能够评估高于8，000 Hz的听力频率;因此，它被认为是监测和诊断接受顺铂的患者早期和无症状耳毒性体征的高质量方法。42例儿童患者使用HFA评估顺铂引起的听力损失，并将其诊断效果与标准纯音测听和畸变产物耳声发射（DPOAE）进行比较。患者人群包括签署知情同意书并于1991年至2008年期间在巴西波尔图医院阿莱格雷儿科接受顺铂化疗的患者。结果42例患者接受了评价。研究评估时的中位年龄为14.5岁（范围437岁）。在常规频率下，24例患者（57%）检测到听力损失。64%的受检者DPOAE改变，36例（86%）受检者在增加高频试验后出现听力损失。在常规频率下，听力受损患者的平均顺铂剂量显著更高（P = 0.046）。结论HFA在检测高频听力损失方面优于纯音听阈和DPOAE。它可能是一个有用的工具，测试新的耳保护剂，除了作为一种早期诊断方法检测听力障碍。儿科血液癌症2013; 60：474-478。(C)2012 Wiley Periodicals，Inc.
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 Clinicas de Porto Alegre Pediatric Unit, Brazil. Results Forty-two patients were evaluated. The median age at study assessment was 14.5 years (range 437 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. (C) 2012 Wiley Periodicals, Inc.