Prevalence of hearing and vestibular loss in cystic fibrosis patients exposed to aminoglycosides

• Published in: Pediatric pulmonology Vol. 52; no. 9; pp. 1157 - 1162
• Main Authors: Handelsman, Jaynee A., Nasr, Samya Z., Pitts, Crystal, King, William M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.09.2017
• Subjects: Adolescent; Adult; aminoglycosides; Aminoglycosides - adverse effects; Anti-Bacterial Agents - adverse effects; Child; Cohort Studies; Cystic fibrosis; Cystic Fibrosis - drug therapy; Cystic Fibrosis - epidemiology; Female; Hearing loss; Hearing Loss - chemically induced; Hearing Loss - epidemiology; Humans; Male; Middle Aged; ototoxicity; Prevalence; Quality of Life; vestibular loss; Young Adult; aminoglycosides; hearing loss; vestibular loss; ototoxicity; cystic fibrosis
• DOI: 10.1002/ppul.23763
• ISSN: 8755-6863

Aim Cystic Fibrosis (CF) patients frequently use aminoglycosides (AGS) to treat CF exacerbation due to colonization with Pseudomonas aeruginosa. Although AGS can cause vestibular and auditory sensory losses that can negatively impact quality of life, little is known about the prevalence of vestibular loss in this population. The aim of this study was to determine the prevalence of hearing loss and/or vestibular dysfunction in CF patients treated with AGS. Methods The relationship between hearing status and vestibular status was also investigated. Hearing was determined to be normal or abnormal based on pure tone air and bone conduction thresholds. Vestibular outcome was divided into four categories; normal, non‐lateralized vestibular dysfunction, unilateral loss, and bilateral loss based on results of post head shaking testing, positional and positioning testing, bithermal calorics, sinusoidal, and rotational step testing. Results Of our cohort of 71 patients, 56 (79%) patients have vestibular system dysfunction while only 15 (21%) have normal vestibular system function. Overall, 16 patients (23%) have hearing loss. In considering the relationship between auditory and vestibular function, 12 (17%) demonstrated both normal hearing and normal vestibular function and 13 (18%) have both hearing loss and abnormal vestibular function. Of the 55 (78%) patients with normal hearing, 43 (61%) have vestibular dysfunction, while 3 (4%) of patients with normal vestibular function have hearing loss. Conclusion These results suggest that monitoring hearing alone is insufficient to detect ototoxicity in CF patients being treated with systemic AGS.