ABSTRACT
Ototoxicity monitoring is particularly critical in patients receiving platinum-based
chemotherapy or long-term aminoglycoside antibiotic administration. Furthermore, as
new otoprotective agents are developed, audiologists need to not only be able to monitor
for ototoxicity but know the various criteria for early detection of ototoxicity and
how to grade ototoxic adverse events. The three primary methods for ototoxicity monitoring
are conventional audiometry, high-frequency audiometry, and otoacoustic emissions.
However, early detection and adverse event criteria depend primarily on conventional
and high-frequency audiometry. No consensus exists on determining significant changes
in otoacoustic emissions secondary to ototoxic drugs. Also, no consensus exists on
how to monitor for tinnitus, although it is a common complication in these patients.
Currently, tinnitus surveys can be helpful. A baseline evaluation is critical for
accurate interpretation of auditory threshold results. Thus, a team approach is needed
to ensure adequate care of these children. For clinical trials and in reading the
literature, audiologists need to be aware of the American Speech Language Hearing
Association's 1994 criteria for detection of ototoxic change, and the Common Terminology
Criteria for Adverse Events, Brock, and the Change scales for classification of adverse
events. These methods and scales are reviewed and discussed.
KEYWORDS
Ototoxicity - pediatric - high-frequency audiometry - ototoxicity monitoring - early
detection - adverse event - grading scales
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Kathleen C.M. CampbellPh.D.
Professor and Director of Audiology Research
Office #3341, 801 N. Rutledge, Southern Illinois University School of Medicine, Springfield,
IL 62702
Email: kcampbell@siumed.edu
