High-frequency audiometric monitoring for early detection of aminoglycoside ototoxicity.
Treatment with aminoglycosides is known to cause irreversible hearing loss, typically affecting higher-frequency hearing first and progressing to lower frequencies. Standardized methodology has not been developed for early detection of ototoxicity. Serial conventional (0.25-8 kHz) and high-frequency (9-20 kHz) hearing threshold monitoring was done prospectively in 53 hospitalized patients administered aminoglycosides. Hearing loss occurred in 47% of the ears studied, with hearing loss first appearing in the high-frequency range in 71% of ears showing change. Analysis of data on an individual basis revealed a five-frequency range most susceptible to initial ototoxicity. Testing only this range would have resulted in early identification of 82% of ears showing change. Results confirm the critical need for serial auditory threshold monitoring encompassing high frequencies in patients receiving aminoglycosides. A shortened five-frequency monitoring protocol is presented and suggested for use with patients unable to tolerate lengthy audiometric testing procedures.
Fausti
S A
SA
Auditory Research Laboratory, VA Medical Center, Portland, Oregon.
Henry
J A
JA
Schaffer
H I
HI
Olson
D J
DJ
Frey
R H
RH
McDonald
W J
WJ
D000583:Amikacin / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001299:Audiometry; D005839:Gentamicins / Q000009:adverse effects; D034381:Hearing Loss / Q000139:chemically induced*; D006312:Hearing Loss, Bilateral / Q000139:chemically induced*; D006316:Hearing Loss, High-Frequency / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014031:Tobramycin / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D000583:Amikacin; D014031:Tobramycin