Early changes in auditory function as a result of platinum chemotherapy: use of extended high-frequency audiometry and evoked distortion product otoacoustic emissions
Early changes in auditory function as a result of platinum chemotherapy: use of extended high-frequency audiometry and evoked distortion product otoacoustic emissions
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DOI：
10.1200/jco.2006.07.9723
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发表时间：
2007-04-01
影响因子：
45.3
通讯作者：
Neuwelt, Edward A.
中科院分区：
文献类型：
--
作者：
Knight, Kristin R.;Kraemer, Dale F.;Neuwelt, Edward A.
目的描述接受铂类药物化疗的儿童和青少年听力和耳蜗功能的进展性变化，并开始初步评价扩展高频测听和畸变产物耳声发射用于儿童耳毒性监测的可行性。对32例年龄8个月~ 20岁，接受顺铂和/或卡铂化疗的患者进行了耳声发射（0.5 ~ 8 kHz）和诱发性畸变产物耳声发射（DPOAE）检查。17名儿童还进行了扩展高频（EHF）测听（9至16 kHz）的基线和系列测量。听力学数据进行了分析，以确定耳毒性的发病率使用美国言语-语言-听力协会标准，和耳toxicity.ResultsOf 32名儿童，20（62.5%）收购双边耳毒性在常规的频率范围内化疗治疗期间，和26（81.3%）有双边DPOAE振幅和动态范围的下降。在17名有EHF听力检查结果的儿童中，16名（94.1%）在EHF范围内有双侧耳毒性。试点数据表明，EHF阈值和DPOAEs显示耳毒性变化之前，听力损失是由传统audiometry.ConclusionEHF测听和DPOAEs有可能揭示早期的听力功能变化比传统的频率测听铂化疗期间的儿童。
PurposeThe objective is to describe progressive changes in hearing and cochlear function in children and adolescents treated with platinum-based chemotherapy and to begin preliminary evaluation of the feasibility of extended high-frequency audiometry and distortion product otoacoustic emissions for ototoxicity monitoring in children.Patients and MethodsBaseline and serial measurement of conventional pure-tone audiometry (0.5 to 8 kHz) and evoked distortion product otoacoustic emissions (DPOAEs) were conducted for 32 patients age 8 months to 20 years who were treated with cisplatin and/or carboplatin chemotherapy. Seventeen children also had baseline and serial measurement of extended high-frequency (EHF) audiometry ( 9 to 16 kHz). Audiologic data were analyzed to determine the incidence of ototoxicity using the American Speech-Language-Hearing Association criteria, and the relationships between the different measures of ototoxicity.ResultsOf the 32 children, 20 (62.5%) acquired bilateral ototoxicity in the conventional frequency range during chemotherapy treatment, and 26 (81.3%) had bilateral decreases in DPOAE amplitudes and dynamic range. Of the 17 children with EHF audiometry results, 16 (94.1%) had bilateral ototoxicity in the EHF range. Pilot data suggest that EHF thresholds and DPOAEs show ototoxic changes before hearing loss is detected by conventional audiometry.ConclusionEHF audiometry and DPOAEs have the potential to reveal earlier changes in auditory function than conventional frequency audiometry during platinum chemotherapy in children.