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Ototoxicity early detection using distortion product otoacoustic emissions

Introduction: Aminoglycosides can lead to ototoxicity, but the traditional auditory monitoring detects ototoxicity just when the injury has already occurred. Aim: A prospectively study of the auditory function of patients in treatment with amicacyn using pure tone audiometry (TA) and distortion product otoacoustic emissions (DPOAE) to detect an early suspicion of ototoxicity and its prevention. Study design: Prospective randomized. Material and method: Twenty-nine patients treated with amicacyn were evaluated with TA to detect audiometric changes. Out of 29 patients, three had audiometric changes in 6 and/or 8 kHz (10.34%), one had bilateral and two had unilateral alteration (four ears). They were all asymptomatic. We performed DPOAE to study the cochlear function. Out of 29 patients (58 ears), nine (18 ears) were excluded because they did not have all DPOAE tests, remaining 20 patients (40 ears) to analyze. Results: No specific tendency was found in the DPOAE records during the serum trough and peak of the drug. In a comparative study of ears with and without audiometric changes, no significant difference was found in the response in 1, 2 and 4 kHz; however, a significant difference was observed in 6 and 8 kHz (p<0.05). We found that DPOAE responses of normal ears presented a larger number of increments than decreases when compared to the others. Conclusions: Ototoxicity can be effectively monitored with DPOAE during drug administration, regardless of time of administration, and 6 and 8 kHz are more sensitive frequencies to realize effective auditory monitoring; the increments in responses can be an early sign of ototoxicity by aminoglycosides.

otoacustic emissions; ototoxicity; monitoring


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