Long-Term Variability of Distortion-Product Otoacoustic Emissions in Infants and Children and Its Relation to Pediatric Ototoxicity Monitoring.
Dawn Konrad-Martin, Kristin Knight, Garnett P McMillan and 3 others
PMID 29280917WHAT IT FOUND
DPOAE levels normally fall with age in healthy children, especially in the first year.
A small later drop may be normal development, not ototoxicity, so compare with normal age-related changes, and 6 kHz is relatively stable.
Key findings
01In healthy children, mean DPOAE levels fall with age, with the largest drop in the first year.
02Adult DPOAE change limits would incorrectly flag healthy children, especially infants and children tested at 2 kHz.
03At 6 kHz, DPOAE level showed little to no age-related drop, and most repeated-measurement differences were about 3 to 4 dB.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The analysed sample was small: 57 children consented, but 38 were analysed, and data were sparse above about 75 months. The sample was not diverse: all participants were white and only one reported Hispanic ethnicity. Children with ear disease, middle ear dysfunction, or poor cooperation were excluded, so results may not apply to children who cannot be tested reliably during cancer treatment. The study measured healthy children, not children receiving cisplatin or carboplatin, so it estimates normal variability but does not prove how to detect ototoxic damage. The reference intervals depend on similar equipment, stimulus levels, and calibration; the authors advise local validation.
Declared interests
The supplied text does not include an author conflict-of-interest or funding declaration. The journal metadata lists research support from U.S. Government, non-PHS.
The easy way to misread this
Do not apply adult DPOAE change limits to children or treat every DPOAE decrease as ototoxicity. Healthy infants were incorrectly flagged at rates about 2 to 3 times expected, and a 7 dB decrease, such as from 12 dB SPL to 5 dB SPL at 6 kHz, can be normal in a 4-month-old but abnormal in a 24-month-old.