High frequency audiometric study in cancer-cured patients treated with cisplatin.

UNLABELLED: Hearing loss has been described in patients undergoing chemotherapy, given the ototoxic nature of these drugs. An audiological investigation is relevant in such cases. AIM: to assess audibility thresholds at high frequencies in individuals with cancer that was treated successfully with cisplatin and its associations, to verify possible hearing loss as a side effect of therapy. Site and date of the study: Campinas, Sao Paulo, in 2006. MATERIAL AND METHOD: Ten volunteers aged between 5 and 27 years were assessed by a clinical history, otoscopy, and conventional and high frequencies audiometry in this clinical and experimental study. RESULTS: A kappa coefficient statistical analysis revealed significant differences between ears in 50% of 14 frequencies that were evaluated. Eight participants presented hearing losses, which started at 1 kHz, increasing markedly at 6 kHz and above. Fisher's Exact Test revealed a significant association only with the dose and the right ear at high frequencies. CONCLUSION: It is possible that the hearing loss detected in this study is at least partially due to the ototoxicity of antineoplastic drugs; such loss may occur even after treatment is interrupted. We suggest that a protocol for audiological follow-up of patients undergoing chemotherapy should be created.

Estudo audiometrico de alta fraquência em pacientes curados de câncer tratados com cisplatina / High frequency audiometric study in cancer-cured patients treated with cisplatin

Alterações auditivas têm sido encontradas em pacientes submetidos à quimioterapia devido à ototoxicidade, daí a importância da investigação audiológica nesses casos. OBJETIVO: Avaliar os limiares de audibilidade nas altas freqüências em indivíduos curados de câncer, tratados com cisplatina e associações, para verificar possível perda auditiva como seqüela do tratamento. Local e data do estudo: Campinas - SP, em 2006. MATERIAL E MÉTODO: Roteiro de anamnese, otoscópio e audiômetro. Dez voluntários, entre 5 a 27 anos, foram submetidos a anamnese; meatoscopia; audiometria tonal convencional e de altas freqüências. Forma de Estudo: Clínico experimental. RESULTADOS: O kappa ponderado evidenciou diferença significativa entre as orelhas em 50 por cento das 14 freqüências avaliadas. Oito participantes apresentaram perda auditiva. O acometimento iniciou-se em 1 kHz, com crescimento acentuado a partir de 6kHz. O Teste Exato de Fisher evidenciou associação significativa apenas para dose e orelha direita nas altas freqüências. CONCLUSÃO: É possível que as perdas auditivas detectadas devam-se, pelo menos parcialmente, à ototoxicidade dos antineoplásicos utilizados, a qual pode ocorrer mesmo após a interrupção do tratamento. Sugere-se estabelecer protocolo de acompanhamento audiológico no tratamento quimioterápico.

Hearing loss has been described in patients undergoing chemotherapy, given the ototoxic nature of these drugs. An audiological investigation is relevant in such cases. AIM: to assess audibility thresholds at high frequencies in individuals with cancer that was treated successfully with cisplatin and its associations, to verify possible hearing loss as a side effect of therapy. Site and date of the study: Campinas, Sao Paulo, in 2006. MATERIAL AND METHOD: Ten volunteers aged between 5 and 27 years were assessed by a clinical history, otoscopy, and conventional and high frequencies audiometry in this clinical and experimental study. RESULTS: A kappa coefficient statistical analysis revealed significant differences between ears in 50 percent of 14 frequencies that were evaluated. Eight participants presented hearing losses, which started at 1 kHz, increasing markedly at 6 kHz and above. Fisher's Exact Test revealed a significant association only with the dose and the right ear at high frequencies. CONCLUSION: It is possible that the hearing loss detected in this study is at least partially due to the ototoxicity of antineoplastic drugs; such loss may occur even after treatment is interrupted. We suggest that a protocol for audiological follow-up of patients undergoing chemotherapy should be created.

Utilidades clínicas da audiometria de altas freqüências / Clinical utilities of high frequency audiometry

Objetivos: Apresenta-se revisão de literatura sobre o tema audiometria de altas freqüências. Métodos: Revisão de bibliográfica utilizando artigos publicados no Medline. Conclusão: A audiometria de altas freqüências é bom método de investigação clínica. Pode integrar o plano de investigação audiológica inicial em casos de exposição a ruído, ototoxicidade e doenças sistêmicas com afetação do sistema auditivo

Vision and hearing during deferoxamine therapy.

To determine the frequency of eye and auditory complications and their relationship to drug dosage and iron stores in patients receiving deferoxamine, we studied 52 regularly transfused patients who received deferoxamine by subcutaneous or intravenous infusion in doses from 26 to 136 mg/kg/day, and whose serum ferritin levels of 185 to 17,775 micrograms/L reflected a wide range of iron stores. Forty-nine patients (94%) had no evidence of drug-induced visual or auditory abnormalities. Symptomatic loss of vision and hearing developed in one patient; both problems improved when chelation therapy was stopped. Of the 51 symptom-free patients, one had a mild degree of macular stippling and one had a mild, bilateral, high-frequency sensorineural hearing loss. Eye and ear abnormalities in the symptom-free patients did not progress despite continuation or resumption of chelation therapy at the same dosage. Patients with ophthalmologic and audiologic abnormalities did not receive higher doses of deferoxamine and did not have lower serum ferritin levels than patients without such abnormalities. These findings demonstrate that eye and ear abnormalities during chelation therapy with deferoxamine may not occur uniformly at as high a frequency as previously reported, even in patients who receive large doses of the chelating agent or who have only modest amounts of excessive iron.