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Distortion-product otoacoustic emission: early detection in deferoxamine induced ototoxicity

Delehaye, Emilio and Capobianco, Francesco Saverio and Bertetto, Ivano Bruno and Meloni, Francesco (2008) Distortion-product otoacoustic emission: early detection in deferoxamine induced ototoxicity. Auris Nasus Larynx, Vol. 35 (2), p. 198-202. ISSN 0385-8146. Article.

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DOI: 10.1016/j.anl.2007.05.001

Abstract

Objective. Deferoxamine therapy in lifelong transfusion-dependent anaemias, as beta-thalassemia major, is associated with an increased risk of ototoxic changes. With increasing survival rates, prevention and/or early detection of ototoxicity are important for providing management options. The predictive value of pure-tone audiometry in early detection of ototoxicity has been questioned, particularly in the higher frequencies. Otoacoustic emissions appear to be more sensitive to cochlear insult than the conventional pure-tone audiometry. The aim of our study was to compare the efficacy of otoacoustic emissions (distortion-product otoacoustic emissions) with that of pure-tone audiometry as method of audiological monitoring.
Methods. Baseline audiometric (0.25–8 kHz) and otoacoustic emission testing (distortion-product otoacoustic emissions) was conducted in a group of patients with beta-thalassemia major, 60 of whom met the criteria for inclusion in the study. Comparisons were performed between baseline measurements and those recorded after 20 months. Distortion-product otoacoustic emissions were obtained as DP-grams. The DP-gram amplitude was determined for each child.
Results. Threshold changes from baseline were found to be statistically significant from 4 to 8 kHz in 68.4% of the subjects (P < 0.01). Distortion-product otoacoustic emissions demonstrated a significant threshold shift and a decreased amplitude in the frequencies >3 kHz (P < 0.05). Furthermore, DP-gram amplitude also reduced significantly at 3 kHz (P < 0.05) without any similar change in pure-tone audiometry.
Conclusions. As ototoxicity screening tool DP-gram was extremely sensitive and superior to pure-tone audiometry. Their use is recommended for regular monitoring of cochlear function, aiming in prevention of permanent damage.

Item Type:Article
ID Code:1976
Status:Published
Refereed:Yes
Uncontrolled Keywords:Deferoxamine, ototoxicity, pure-tone audiometry, distortion-product otoacoustic emissions
Subjects:Area 06 - Scienze mediche > MED/32 Audiologia
Area 06 - Scienze mediche > MED/31 Otorinolaringoiatria
Divisions:001 Università di Sassari > 03 Istituti > Oftalmologia, Otorinolaringoiatria e Urologia
Publisher:Elsevier Ireland
ISSN:0385-8146
Deposited On:18 Aug 2009 10:06

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