AI Article Synopsis

  • The study focused on the occurrence of hearing loss among patients with multi-drug-resistant tuberculosis (MDR-TB) who were treated with aminoglycosides, revealing significant audiological effects over six months.
  • Hearing loss, primarily bilateral sensorineural, affected 52% of participants just one month after starting treatment, with progression noted from mild to profound levels by the end of the study.
  • The research underscores the need for high-frequency audiometry in monitoring ototoxicity, as traditional methods may miss early signs of hearing impairment, highlighting the importance of providing audiological services to this vulnerable patient group.

Article Abstract

Background: The increased incidence of multi-drug-resistant tuberculosis (MDR-TB) and the consequent use of aminoglycosides with their ototoxic potential necessitate a better understanding of the audiological pattern of infected patients.

Objective: To describe the occurrence and nature of hearing loss in patients with MDR-TB receiving aminoglycosides over a period of 6 months.

Methods: Baseline and five consecutive monthly audiological assessments were conducted on 52 adults at a hospital in KwaZulu-Natal. A longitudinal descriptive study was implemented. A conventional audiological test battery, extended high frequency audiometry and otoacoustic emission testing were conducted. Data were analysed using SPSS version 19 statistical software package.

Results: Decreased hearing was the most common audiological symptom experienced. Bilateral sensorineural hearing loss was predominant. Ototoxic hearing loss was noted in 27 participants (52%) in 1 month post-treatment. Hearing loss progressed from mild to moderate at post-treatment one, to moderate to severe at post-treatment three and severe to profound at post-treatment five. Changes in hearing function were noted in 52 participants (100%) by post-treatment five. High and ultra-high frequencies were most affected. Speech discrimination scores deteriorated over time. The number of patients with absent distortion product otoacoustic emissions increased over treatment duration.

Conclusion: The greatest effects were observed in the high frequencies before manifesting in the lower frequencies. This highlights the importance of inclusion of high frequency audiometry in the early detection of ototoxicity which can go undiagnosed with traditional audiometry. The high prevalence of hearing loss has implications for the provision of audiological service to this patient population.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843187PMC
http://dx.doi.org/10.4102/sajcd.v63i1.154DOI Listing

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