Chirp-Evoked Otoacoustic Emissions and Middle Ear Absorbance for Monitoring Ototoxicity in Cystic Fibrosis Patients.
Angela C Garinis, Douglas H Keefe, Lisa L Hunter and 5 others
PMID 28708814WHAT IT FOUND
Chirp-evoked otoacoustic emissions identified CF ears with high-frequency hearing loss, but they missed a confirmed shift near the top of the tested range in a case.
They may help monitoring, not replace hearing tests.
Key findings
01TEOAE signal-to-noise ratios were smaller in CF ears with sensorineural hearing loss than in CF ears with normal hearing.
02At 5.7 kHz and 8 kHz, TEOAE signal-to-noise ratio areas under the curve were 0.80 and 0.85 or larger for identifying sensorineural hearing loss.
03A confirmed hearing shift at 6 kHz and 8 kHz was not accompanied by persistent TEOAE or absorbance changes.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study could not test CF patients before any aminoglycoside exposure, so baseline hearing may already include ototoxic damage. Only seven ears had a confirmed ASHA shift; of 42 ears with an ASHA shift, 24 could not be confirmed because follow-up was insufficient. TEOAEs were analysed only up to 8 kHz because the stimulus produced insufficient energy above 8 kHz, while ototoxic damage can begin at higher frequencies. The sensorineural hearing loss group included only CF ears, so it is unknown whether the same test performance applies to other patients. Middle ear changes may affect TEOAE and absorbance results, and the relationship among absorbance, TEOAEs, and hearing thresholds needs more research. The four case studies describe individual ears and cannot establish how often the tests detect ototoxicity.
Declared interests
The supplied metadata lists NIH extramural research support. The article text provided does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not read the high-frequency test results as proof that these otoacoustic emissions detect every early ototoxic hearing shift. A participant had confirmed hearing shifts at 6 kHz and 8 kHz without persistent TEOAE or absorbance changes.