title: The use of high-frequency audiometry increases the diagnosis of asymptomatic hearing loss in pediatric patients treated with cisplatin-based chemotherapy.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Children's Cancer Institute, Porto Alegre, Brazil.
authors: Ana Lucia
authors: AL
authors: Abujamra
authors: Juliana Ribas
authors: JR
authors: Escosteguy
authors: Celso
authors: C
authors: Dall'Igna
authors: Denise
authors: D
authors: Manica
authors: Luciana Facchini
authors: LF
authors: Cigana
authors: Patrícia
authors: P
authors: Coradini
authors: André
authors: A
authors: Brunetto
authors: Lauro José
authors: LJ
authors: Gregianin
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001299:Audiometry / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin