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囊性纤维化患者的高频听力阈值及畸变产物耳声发射

High frequency hearing thresholds and product distortion otoacoustic emissions in cystic fibrosis patients.

作者信息

Geyer Lucia Bencke, Menna Barreto Sergio Saldanha, Weigert Liese Loureiro, Teixeira Adriane Ribeiro

机构信息

Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.

Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Toronto University, Toronto, Canada.

出版信息

Braz J Otorhinolaryngol. 2015 Nov-Dec;81(6):589-97. doi: 10.1016/j.bjorl.2015.08.011. Epub 2015 Sep 8.

Abstract

INTRODUCTION

The treatment of patients with cystic fibrosis involves the use of ototoxic drugs, mainly aminoglycoside antibiotics. Due to the use of these drugs, fibrocystic patients are at risk of developing hearing loss.

OBJECTIVE

To evaluate the hearing of patients with cystic fibrosis by High Frequency Audiometry and Distortion Product Otoacoustic Emissions.

METHODS

Cross-sectional study. The study group consisted of 39 patients (7-20 years of age) with cystic fibrosis and a control group of 36 individuals in the same age group without otologic complaints, with normal audiometric thresholds and type A tympanometric curves. High Frequency Audiometry and Distortion Product Otoacoustic Emissions tests were conducted.

RESULTS

The study group had significantly higher thresholds at 250, 1000, 8000, 9000, 10,000, 12,500, and 16,000Hz (p=0.004) as well as higher prevalence of otoacoustic emission alterations at 1000 and 6000Hz (p=0.001), with significantly lower amplitudes at 1000, 1400, and 6000Hz. There was a significant association between alterations in hearing thresholds in High Frequency Audiometry with the number of courses of aminoglycosides administered (p=0.005). Eighty-three percent of patients who completed more than ten courses of aminoglycosides had hearing loss in High Frequency Audiometry.

CONCLUSION

A significant number of patients with cystic fibrosis who received repeated courses of aminoglycosides showed alterations in High Frequency Audiometry and Distortion Product Otoacoustic Emissions. The implementation of ten or more aminoglycoside cycles was associated with alterations in High Frequency Audiometry.

摘要

引言

囊性纤维化患者的治疗涉及使用耳毒性药物,主要是氨基糖苷类抗生素。由于使用这些药物,纤维囊性患者有发生听力损失的风险。

目的

通过高频听力测定法和畸变产物耳声发射评估囊性纤维化患者的听力。

方法

横断面研究。研究组由39例7至20岁的囊性纤维化患者组成,对照组为36名同年龄组无耳科主诉、听力阈值正常且鼓室导抗图为A型曲线的个体。进行了高频听力测定法和畸变产物耳声发射测试。

结果

研究组在250、1000、8000、9000、10000、12500和16000Hz处的阈值显著更高(p = 0.004),在1000和6000Hz处耳声发射改变的患病率也更高(p = 0.001),在1000、1400和6000Hz处的振幅显著更低。高频听力测定法中听力阈值的改变与氨基糖苷类药物的给药疗程数之间存在显著关联(p = 0.005)。完成十多个氨基糖苷类疗程的患者中,83%在高频听力测定法中有听力损失。

结论

大量接受重复氨基糖苷类疗程的囊性纤维化患者在高频听力测定法和畸变产物耳声发射中出现改变。实施十个或更多氨基糖苷类周期与高频听力测定法的改变有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8d2/9442703/b48ab876b69b/gr1.jpg

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