title: The role of routine hearing screening in children with cystic fibrosis on aminoglycosides: A systematic review.
abstract: OBJECTIVE
  To review the role of routine hearing screening for sensorineural hearing loss (SNHL) in children with cystic fibrosis (CF) who have been on aminoglycoside therapy.
  
  
  METHODS
  PubMed, Cochrane, Scopus, and Ovid databases.
  
  
  METHODS
  A systematic review of the literature was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search was performed from 1970 to 2014. Randomized controlled trials, case-control studies, cohort studies, and case series including pediatric subjects with baseline auditory evaluations were included.
  
  
  RESULTS
  Twelve studies (1979-2014) were reviewed. The study population included 762 children (5 months-20 years). Hearing screening measures included pure-tone audiometry (PTA) at standard ± high frequency threshold (HFPTA) (12/12), distortion product otoacoustic emissions (DPOAE) (4/12), transient-evoked otoacoustic emissions (1/12), and automated auditory brainstem response (1/12). The overall prevalence of SNHL ranged from 0% to 29%. However, on subset analysis of children with greater than 10 courses of intravenous (IV) aminoglycosides, up to 44% had SNHL. Eight studies recommended hearing screening in CF children on aminoglycosides; of these, two studies recommended screening even without aminoglycoside exposure, and four studies made no recommendations. HFPTA was the most commonly recommended screening measure followed by DPOAEs.
  
  
  CONCLUSIONS
  This systematic review supports a recommendation for clinicians to perform routine hearing screening in children with CF during and after aminoglycoside exposure based on the high prevalence of SNHL in this population. Future studies should define the optimal timing for hearing screening during and after aminoglycoside therapy in children with CF.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.|Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Farzal
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Yann-Fuu
authors.initials: YF
authors.lastname: Kou
authors.affiliation: Division of Pediatric Otolaryngology-Head and Neck Surgery, Children's Medical Center, Dallas, Texas, U.S.A.
authors.forename: Rachel
authors.initials: R
authors.lastname: St John
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.|Division of Pediatric Otolaryngology-Head and Neck Surgery, Children's Medical Center, Dallas, Texas, U.S.A.
authors.forename: Gopi B
authors.initials: GB
authors.lastname: Shah
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.|Division of Pediatric Otolaryngology-Head and Neck Surgery, Children's Medical Center, Dallas, Texas, U.S.A.
authors.forename: Ron B
authors.initials: RB
authors.lastname: Mitchell
mesh_terms: D000293:Adolescent; D000617:Aminoglycosides / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000188:drug therapy*; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D055815:Young Adult
chemical_list: D000617:Aminoglycosides
keywords: Cystic fibrosis; aminoglycosides; hearing loss; hearing screening; pediatric; systematic review